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ARTICLE HISTORY Received 25 February 2024; Accepted 9 March 2024
CONTACT Jane Abrams JAbramsDSW@gmail.com School of Social Policy and Practice, University of Pennsylvania United States, Philadelphia, PA, USA
In his article “Unsuccessful Accommodations: Reconceptualizing the Psychopathology Attributed to Neuropsychological Deficits,” Joseph Palombo (2023) challenges the linear view that a diagnosis of a condition with neuropsychological deficits will result in a predetermined outcome. He defines such disorders or syndromes with neurocognitive deficits - for example, dyslexia, executive functioning disorders, and nonverbal learning disabilities - as limitations of the person’s capacity to perform a task that is required of them. Considered neuroatypical, people with neuropsychological deficits often cannot succeed in what they wish to accomplish. The deficits often are multidimensional and can include cooccurrences in more than one area. He uses the term “unsuccessful accommodations” to describe the neuroatypical person’s failures to achieve their goals.
Palombo’s central argument is that a neuropsychological deficit does not necessarily predict an unsuccessful accommodation. His focus is on the complexity of each individual and their interactions with their environments. Outcomes depend on multiple factors, such as the nature of the disorder, the strengths of the individual, temperament, and conditions in the person’s environment. “Successful accommodation may result when deficits are complemented by others who provide the missing function or when the environment can be modified” (p. 8).
Palombo emphasizes the role of a person’s subjectivity and the ways in which their deficits filter their experience, affecting the meanings they construct of their experiences. Unsuccessful accommodations can lead to feelings of shame, attempts to hide deficits, defenses such as disavowal and dissociation - all of which can interfere with relationships. Palombo refers to these experience