Adults with Aspergers Seem 'Normal' to Me

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Maerlyn138
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28 Apr 2012, 9:09 am

Joe90 wrote:
These sorts of threads always end up in arguments then getting locked. Some people seem to think that there is no difference between severe Autism and mild AS because severe traits can overlap mild traits and that every Autistic person is different, which is very true, but again there's an answer we will never find.


Agree, I started off....at least my memory starts off, being very impaired in elementary school, junior high, and the first part of high school. However over the years I have built up a functioning persona to use at work (of course it has to be remade if I change jobs, but it's basically the same). This mask is very thin though and begins to crack if i get out of my comfort zone or start to actually hang out with people after work or something.

Impairments in other areas has also improved over the years. Probably would've gone faster if I hadn't gotten married twice. Then I could've spent move time on self improvement. But, maybe the experience was good for me :\ who knows.


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28 Apr 2012, 9:23 am

Joe90 wrote:
These sorts of threads always end up in arguments then getting locked. Some people seem to think that there is no difference between severe Autism and mild AS because severe traits can overlap mild traits and that every Autistic person is different, which is very true, but again there's an answer we will never find.


Why do you consistently misrepresent what people are saying when you comment in threads like this? No one has said that there is no difference between severe autism and mild AS. I do not recall this ever having been said since I've joined this forum, but every time the topic comes up you make this claim.



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28 Apr 2012, 10:16 am

Verdandi wrote:
Joe90 wrote:
These sorts of threads always end up in arguments then getting locked. Some people seem to think that there is no difference between severe Autism and mild AS because severe traits can overlap mild traits and that every Autistic person is different, which is very true, but again there's an answer we will never find.


Why do you consistently misrepresent what people are saying when you comment in threads like this? No one has said that there is no difference between severe autism and mild AS. I do not recall this ever having been said since I've joined this forum, but every time the topic comes up you make this claim.


Hmm so when the Asperger's Diagnosis disappears, how are thy going to preceisely differentiate the very specific differences between severe autism and mild Aspergers when they've only got three sub-categories of severity within the Autism Spectrum Disorder category:-

http://www.dsm5.org/ProposedRevision/Pa ... px?rid=94#

Level 1 - Requiring Support

Level 2 - Requiring Substantial Support

Level 3 - Requiring Very Substantial Support

Which level of support do people consider themselves as needing?



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28 Apr 2012, 10:21 am

Verdandi wrote:
Joe90 wrote:
These sorts of threads always end up in arguments then getting locked. Some people seem to think that there is no difference between severe Autism and mild AS because severe traits can overlap mild traits and that every Autistic person is different, which is very true, but again there's an answer we will never find.


Why do you consistently misrepresent what people are saying when you comment in threads like this? No one has said that there is no difference between severe autism and mild AS. I do not recall this ever having been said since I've joined this forum, but every time the topic comes up you make this claim.


I haven't actually made this point for ages. My new confusion now is the ''NTs and empathy'' thing. It's just that before when I made a ''differences between severe Autism and mild AS'' thread people claimed that there is no difference between the two.


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28 Apr 2012, 10:23 am

nessa238 wrote:
Verdandi wrote:
Joe90 wrote:
These sorts of threads always end up in arguments then getting locked. Some people seem to think that there is no difference between severe Autism and mild AS because severe traits can overlap mild traits and that every Autistic person is different, which is very true, but again there's an answer we will never find.


Why do you consistently misrepresent what people are saying when you comment in threads like this? No one has said that there is no difference between severe autism and mild AS. I do not recall this ever having been said since I've joined this forum, but every time the topic comes up you make this claim.


Hmm so when the Asperger's Diagnosis disappears, how are thy going to preceisely differentiate the very specific differences between severe autism and mild Aspergers when they've only got three sub-categories of severity within the Autism Spectrum Disorder category:-

http://www.dsm5.org/ProposedRevision/Pa ... px?rid=94#

Level 1 - Requiring Support

Level 2 - Requiring Substantial Support

Level 3 - Requiring Very Substantial Support

Which level of support do people consider themselves as needing?


The message in DSMV is self evident. If you have been diagnosed with AS in the past, but your symptoms are so mild that you require "no" support to function in NT society then you are deemed no longer on the ASD spectrum.

Honestly I can;t understand the logic of people who are desperate to get an official AS Dx when they turn around and claim they function quite well in NT society?

I anticipate many current AS Dx will say they require mental health services (i.e. counselling) to cope with stress. So the answer simply is they fall into Level 1. End of story.



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28 Apr 2012, 10:38 am

cyberdad wrote:
nessa238 wrote:
Verdandi wrote:
Joe90 wrote:
These sorts of threads always end up in arguments then getting locked. Some people seem to think that there is no difference between severe Autism and mild AS because severe traits can overlap mild traits and that every Autistic person is different, which is very true, but again there's an answer we will never find.


Why do you consistently misrepresent what people are saying when you comment in threads like this? No one has said that there is no difference between severe autism and mild AS. I do not recall this ever having been said since I've joined this forum, but every time the topic comes up you make this claim.


Hmm so when the Asperger's Diagnosis disappears, how are thy going to preceisely differentiate the very specific differences between severe autism and mild Aspergers when they've only got three sub-categories of severity within the Autism Spectrum Disorder category:-

http://www.dsm5.org/ProposedRevision/Pa ... px?rid=94#

Level 1 - Requiring Support

Level 2 - Requiring Substantial Support

Level 3 - Requiring Very Substantial Support

Which level of support do people consider themselves as needing?


The message in DSMV is self evident. If you have been diagnosed with AS in the past, but your symptoms are so mild that you require "no" support to function in NT society then you are deemed no longer on the ASD spectrum.

Honestly I can;t understand the logic of people who are desperate to get an official AS Dx when they turn around and claim they function quite well in NT society?

I anticipate many current AS Dx will say they require mental health services (i.e. counselling) to cope with stress. So the answer simply is they fall into Level 1. End of story.


Yes exactly

Which seems to make the whole discovery/invention of the AS diagnosis a waste of time in the first place as we're now back to square one with it ceasing to exist in the diagnostic manual!

When DSM V comes out, what if a person who thinks they might have the traits which might previously have been diagnosed as Aspergers going to be diagnosed with if their 'problems' aren't sufficient to need support? They won't be diagnosed with anything in my opinion and even if they are they will be pointed in the diection of, as you say, either mental health services and/or services being provided for people with Autism and these people will invariably also have a Learning Disability so the service won't be appropriate for a person with normal IQ ie the support needs will be of a completely different nature

I know one thing - the onus on councils/the NHS to provide any Asperger-specific support services will be zero! The DSM-V's getting rid of Aspergers as a diganosis will be an absolute gift to them in not having to provide anything but standard Autism/LD services!

A person will say "I have Aspergers, I need support" and they will reply "Er that diagnosis no longer exists; if you have Autism there's the Autism service (which will be predominantly for those with classic autism, with accompanying LD) which we only provide for people with a certain high level of need and your level of need isn't high enough so doesn't qualify for help' -I can see it coming a mile off!



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28 Apr 2012, 10:44 am

Well, seeing as how I went from someone who would have been labeled severely autistic (prior to age 4) to someone who now has symptoms of mild to moderate Asperger's, I kind of fail to see your point Joe.
One of the truths about this spectrum thing, is we can move up & down on it.
As for thos arguing that the term disability is something to avoid, well, I do not see it. Autism is a disability, just like being blind is. Yes, both groups learn to compensate, but still..
Biology is biology. We are not talking about personality, emotional, or psychological issues. Every single study ever done has pretty much buried that old whipping boy..

Sincerely,
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28 Apr 2012, 10:47 am

Matt62 wrote:
Well, seeing as how I went from someone who would have been labeled severely autistic (prior to age 4) to someone who now has symptoms of mild to moderate Asperger's, I kind of fail to see your point Joe.
One of the truths about this spectrum thing, is we can move up & down on it.
As for thos arguing that the term disability is something to avoid, well, I do not see it. Autism is a disability, just like being blind is. Yes, both groups learn to compensate, but still..
Biology is biology. We are not talking about personality, emotional, or psychological issues. Every single study ever done has pretty much buried that old whipping boy..

Sincerely,
Matthew


So which level of support need would you class yourself as under the DSM-V proposed severity levels? 1, 2 or 3?

Level 1 - Requiring Support

Level 2 - Requiring Substantial Support

Level 3 - Requiring Very Substantial Support

http://www.dsm5.org/ProposedRevision/Pa ... px?rid=94#



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28 Apr 2012, 11:24 am

nessa238 wrote:
So which level of support need would you class yourself as under the DSM-V proposed severity levels? 1, 2 or 3?

Level 1 - Requiring Support

Level 2 - Requiring Substantial Support

Level 3 - Requiring Very Substantial Support

http://www.dsm5.org/ProposedRevision/Pa ... px?rid=94#


Requiring support of some kind (at the very least counseling, or the fact that they rely heavily on family) is already a(n at least unspoken, though I'd say the manuals are to be interpreted that way) norm to get a diagnosis. I can't see the big difference people claim is represented by the new DSM, and to be honest, I think a lot of people overestimate the changes it will cause. The professionals who already ignore that criterium, will continue to do so - it's not like most professionals religiously adhere to the DSM. As some psychologist once told me, "the ones who do, should be in research, not therapy". I'm very happy I've had therapists who don't - the one that diagnosed me with AS even said she had to think through the diagnosis a few extra times because I fit almost *too* well with diagnostic criteria, close to being a stereotype of a medium-functioning aspie. The reason she decided I wasn't faking it (and rightly so), was extended observation, and interviews with my family.

The fact that the name "Asperger's syndrome" is removed from the manual, doesn't mean the discovery and research has been useless - on the contrary. It made professionals aware there even exist higher-functioning individuals with autism, and far too late at that - it's beyond me how his research could go unnoticed until the 80ies. Asperger himself used the name "autistic psychopathy" if I remember right (psychopathy = mental/personality disorder in older psychiatric language, but you probably already knew that), the name Asperger's syndrome wasn't coined by him. So I don't see the big difference - the new diagnosis is closer to the name he used for the condition he discovered. Putting myself in the risk of putting applause in a deceased person's hands, I'm sure he would applaud the name change, as I get the feeling he was a rather modest guy, judging from his writings and biographies.

Personally, I'd probably be counted as level 2. I'm in in the "more disabled than he looks, even to secondary support workers" category, like the ones who assess my vocational abilities and don't see me over an extended time. The only reason I only have semi-substantial support from public services, is a patient family who provide support I'd have to get from the public sector otherwise.



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28 Apr 2012, 2:15 pm

nessa238 wrote:
Joe90 wrote:
These sorts of threads always end up in arguments then getting locked. Some people seem to think that there is no difference between severe Autism and mild AS because severe traits can overlap mild traits and that every Autistic person is different, which is very true, but again there's an answer we will never find. There is no logic to this sort of thing. I'm a mild Aspie myself, and I am, like, almost the opposite to my friend's brother, who is so severely Autistic that he lives in a care home and needs 24-hour care and can't function at all in society, and he is 24. So how come I'm expected to function in society? I can't get benefits, I can't even get the right support because they say I'm too ''normal''. I'm just forced to go on job-seekers like everybody else and look for a job, maybe getting a little extra support from the job centre, like seeing a Disability Employment Advisor, but that's as far as it goes.

And how come some disabled children are sent to mainstream school and others are sent to a special school? I was sent to mainstream school, and the other special needs kids there also had conditions as mild as mine, like Dyspraxia, Dyslexia, learning difficulties, and ADHD, and other conditions. But when I watched a documentary once about kids at a special school, they all had things like Cerebral Palsy, Down's Syndrome, Mental Retardation, severe cases of Autism, and other conditions. There was a big difference. How come none of them were sent to mainstream school but people like me were?


The reason a person get sent to a special school is usually because they have a below average level IQ or a condition that is associated with having a below average IQ ie it is assumed they don't have the intellectual ability needed for education at a mainstream school. Children are tested before they enter the school system and during schooling and some of these tests would be to test the child's IQ/find out whether the child had learning disabilites and then they would tend to get sent to a special school if they didn't get a high enough score on the tests. Borderline people with normal IQ but a condition like AS probably benefit more from mainstream schooling in my opinion as they have the chance to get decent qualifications as opposed to having not much expected of them at a special school.

Saying that, I've met a person with Aspergers in the past who told me he was sent to a special school but he had an average to above average IQ so they'd messed up basically. His education really suffered as the teaching wasn't suited to his intellectual ability. It depends on what category the medical and education establishments put you in and also what category your own parents put you in. If you do nothing to indicate to teachers/caregivers that you have a lower level of intelligence than average or that you wouldn't cope with mainstream schooling, you will tend to go to a mainstream school.

I think a lot of it can come from a person's own parents - ie if they think there's something wrong with their child ie that they aren't 'normal' and that they lack intelligence then this can lead to the child being judged stupid and in need of special schooling, when it could just be neurodoversity and in no way indicative of a lower IQ.

no, many aspies have attended special classes and special schools. keep in mind that they have to have average to above average IQs in order to receive the diagnosis. their parents don't have to insist on it, as it really depends on the individual aspie. some have behaviour issues, for example.


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28 Apr 2012, 2:19 pm

hyperlexian wrote:
nessa238 wrote:
Joe90 wrote:
These sorts of threads always end up in arguments then getting locked. Some people seem to think that there is no difference between severe Autism and mild AS because severe traits can overlap mild traits and that every Autistic person is different, which is very true, but again there's an answer we will never find. There is no logic to this sort of thing. I'm a mild Aspie myself, and I am, like, almost the opposite to my friend's brother, who is so severely Autistic that he lives in a care home and needs 24-hour care and can't function at all in society, and he is 24. So how come I'm expected to function in society? I can't get benefits, I can't even get the right support because they say I'm too ''normal''. I'm just forced to go on job-seekers like everybody else and look for a job, maybe getting a little extra support from the job centre, like seeing a Disability Employment Advisor, but that's as far as it goes.

And how come some disabled children are sent to mainstream school and others are sent to a special school? I was sent to mainstream school, and the other special needs kids there also had conditions as mild as mine, like Dyspraxia, Dyslexia, learning difficulties, and ADHD, and other conditions. But when I watched a documentary once about kids at a special school, they all had things like Cerebral Palsy, Down's Syndrome, Mental Retardation, severe cases of Autism, and other conditions. There was a big difference. How come none of them were sent to mainstream school but people like me were?


The reason a person get sent to a special school is usually because they have a below average level IQ or a condition that is associated with having a below average IQ ie it is assumed they don't have the intellectual ability needed for education at a mainstream school. Children are tested before they enter the school system and during schooling and some of these tests would be to test the child's IQ/find out whether the child had learning disabilites and then they would tend to get sent to a special school if they didn't get a high enough score on the tests. Borderline people with normal IQ but a condition like AS probably benefit more from mainstream schooling in my opinion as they have the chance to get decent qualifications as opposed to having not much expected of them at a special school.

Saying that, I've met a person with Aspergers in the past who told me he was sent to a special school but he had an average to above average IQ so they'd messed up basically. His education really suffered as the teaching wasn't suited to his intellectual ability. It depends on what category the medical and education establishments put you in and also what category your own parents put you in. If you do nothing to indicate to teachers/caregivers that you have a lower level of intelligence than average or that you wouldn't cope with mainstream schooling, you will tend to go to a mainstream school.

I think a lot of it can come from a person's own parents - ie if they think there's something wrong with their child ie that they aren't 'normal' and that they lack intelligence then this can lead to the child being judged stupid and in need of special schooling, when it could just be neurodoversity and in no way indicative of a lower IQ.

no, many aspies have attended special classes and special schools. keep in mind that they have to have average to above average IQs in order to receive the diagnosis. their parents don't have to insist on it, as it really depends on the individual aspie. some have behaviour issues, for example.


I see

Well I left school in 1983 so the As diagnosis wasn't in existence then
and I didn't have any behaviour issues at school that would have indicated anything was
'wrong' - it's usually when you start hitting people or yelling that people start noticing you and I was the complete opposite of this! Most people weren't even aware I was there let alone aware I was having any problems!



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28 Apr 2012, 4:02 pm

Erm....

I'll just go ahead and set off the dynamite:

In regards to the question of "disability," official diagnoses of "autism spectrum disorder" should be reserved for people are actuality experiencing impairments in their daily lives.

The confusion comes from the glut of individuals who seem to want to embrace "Aspergers" as a "personality type" and who don't require support. Personally, I don't get it. The DSM-IV and the ICD-10 are not big books of "personality-types," they're intended as a means to diagnose dysfunction. I have no problem with people who want to say they have autistic "traits," or they can identify with Aspergers, but I don't understand the drive to get labeled with what is essentially intended to be thought of as a "disorder." If nothing else, the new criteria will at least put the teeth back into the DX process.

My easy solution: people who require support get an ASD DX; people who do not require support can simply identify as having "autistic traits." There's nothing stopping people from focusing on and working at improving specific areas of difficultly, such as social awkwardness or anxiety..........except for the all-consuming desire for a "label." Heck, most of the more reputable shrinks I know are more concerned with assisting people with difficulties than slacking people with diagnoses.

I only got DXed because I was failing at life. I have no issue losing my sacred official DX if my circumstances change and it turns out I need absolutely no help whatsoever to keep my head above water.

Let the vehement disagreements begin.


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28 Apr 2012, 4:43 pm

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Erm....


Mostly, I agree. If there's no dysfunction, there's no need for a diagnosis. I realized I probably had AS years before I asked for an assessment. Reason? I didn't feel like I needed support until then. If I had come to my doctor and asked for an assessment only because I can identify with personality traits, he'd make sure I actually didn't have a dysfunction, and then tell me it's subclinical and no point investigating.

On the other hand, some doctors and public offices tend to think the opposite way - if you don't have a diagnosis, you don't need support. The danger of making the criteria too strict, is that people who need support can be denied it. "You're subclinical/don't have AS, request denied." Thing is, support and dysfunction can be so many things, and not needing support from the public sector now, doesn't mean you won't need it in the future. And if the first assessment concludes that you don't have AS because you're not in the need of support right now, good luck on getting a reassessment when the situation gets worse.

But after having read through the new DSM, I'm not sure I see what the giant difference is, in practice. Okay, some trigger happy professionals will have to become more strict. But I have yet to hear about someone who was diagnosed with no dysfunction and no need for support (if it's only counseling, that's support too). As you say, manuals are there to diagnose dysfunction. I have yet to meet a health professional who hands out diagnoses if there's no dysfunction, as that's simply not good for the patient. I'll never get proper life insurance, since I'm both bipolar and have AS (that's not mentioning hyper-allergies, familiar hypercholesterolemy, asthma and possible narcolepsy). Back when I got the bipolar diagnosis and started taking mood stabilizers, the doctor held off on recording the diagnosis until I had a hypomania that sent me to hospital. Until that, I was better off with a unipolar diagnosis due to insurance, career possibilities, etc. In general, a doctor who hands out diagnoses to people who don't need it, is a bad doctor.

Still, as I said, underdiagnosis is just as problematic as overdiagnosis. If the assessment reveals that you *have* AS (from childhood records/stories and your current state), but are not currently in need of support, with emphasis on currently, it should conclude that you have AS. If not, some professionals may just say your previous assessment said you didn't have AS, when you actually need that support. That's different from overdiagnosis; it's an acknowledgement that you have AS serious enough to make you need support for it if your situation changes. And not needing support at the present time doesn't mean you don't have any dysfunction, it just means your current circumstances make that dysfunction manageable. Before I moved three years ago, I had the same dysfunctions, but due to a stable group of friends and otherwise naturally accommodating environment, I made it without (substantial) support. That changed very fast when I moved. On the other hand, seeking a diagnosis without need for support isn't much use unless you need a confirmation of what has caused your problems. For some, that might be important, not only for oneself, but also to be able to explain to friends and family what's been causing one's behavior etc. Even that is a kind of support, as being able to give a reason might make work, family life and education much easier.



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28 Apr 2012, 4:50 pm

what does the levels of support mean? I do not know which one I am in.



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28 Apr 2012, 4:55 pm

If you need support, you get DXed. If you currently don't need support, you don't get DXed.

If you have "issues" that MIGHT require you to need support in the future, you should work on those issues while postponing the DX until you actually need support.

What's wrong with working on social skills with your shrink? Is there something preventing people with no DX of autism from working on their social skills with their shrink? No. I don't see the value of slapping people with a diagnostic label who "might" need support at some undefined moment in time in the future.

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Thing is, support and dysfunction can be so many things, and not needing support from the public sector now, doesn't mean you won't need it in the future.


I didn't say "support" was limited to "government support."


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28 Apr 2012, 7:11 pm

XFilesGeek wrote:
If you need support, you get DXed. If you currently don't need support, you don't get DXed.

If you have "issues" that MIGHT require you to need support in the future, you should work on those issues while postponing the DX until you actually need support.


I agree, but that's from the patient's perspective. From a doctor's perspective (I'm not a doctor, by the way), if an assessment is already under way (let's say the patient's general practitioner referred him or her), the patient's (possible) future needs should be taken into account. The best thing would be to convince the patient to postpone a diagnosis until the need arises, but sometimes either the patient insists (which pretty much is a sign that he or she at the very least needs emotional support), or the referring doctor, workplace psychologist or similar makes a referral that isn't strictly necessary. In those cases, the specialist should conclude according to the patient's symptoms, with future needs in mind.

Quote:
What's wrong with working on social skills with your shrink? Is there something preventing people with no DX of autism from working on their social skills with their shrink? No. I don't see the value of slapping people with a diagnostic label who "might" need support at some undefined moment in time in the future.


Nothing is wrong with that. On the contrary, more people should see a therapist. And nothing prevents them, except in some cases economy. And I didn't say anyone should be slapped with a diagnostic label. As a matter of fact, unless you are committed, which typically only happens if you're severely depressed or psychotic, you'll never be diagnosed against your will. You can always say no to an assessment. So being slapped with a label will only happen if you (or your parents, I'll admit that may count as a slapping) asked for it. But if the patient wants a full assessment (which I said might not be the "smart thing" if not needed, but for some people the "best thing" may not always be the "smart thing"), or an assessment already is underway for some other reason (unnecessary referral), it's better to get the label than have your journal say you *don't have* the condition, as some professionals misinterpret that to be a permanent conclusion. After all, AS is genetic, so if you didn't have it five years ago (as an adult), you shouldn't have it now. The correct diagnosis then would be AS without current need for practical support. That may perhaps not fit quite in with the new DSM, but it would in my opinion fit with the purpose, acknowledging the patient has a disorder that would cause him/her trouble in other situations. A doctor who views diagnostic manuals as religious scripture and his job as filling out check lists, is a doctor I wouldn't want to see. But this is highly hypothetical anyway, I very much doubt many people would seek a diagnosis if they didn't have a need for support on some level or another. Few people want labels unless the label would improve their situation.

Also, regarding economy: While working on social skills (or any other problem) with your shrink is possible with no diagnosis, it is expensive. In those countries where appointments are covered *if there is a medical reason for them*, that is most definitely a significant need for support. In such case, a diagnosis would secure future therapy - I would not be able to afford a psychologist without coverage.

Quote:
I didn't say "support" was limited to "government support."


I didn't say you said so either ;-) But plenty of people think so, including a huge amount of health professionals, hence my mentioning it. Living in a country with public welfare (which has its blessings, no doubt), I meet that attitude weekly.