I. Phonocentrism and Protocol

Derrida’s critique of phonocentrism — the privileging of speech as immediacy, as presence, as the site of truth and selfhood — has clear implications when mapped onto institutional expectations:

• Institutions (including mental health systems, legal systems, welfare, education) demand you show up, speak up, be coherent, be present.

• This “presence” is not just spatial-temporal but epistemic: to be recognizable, you must communicate in the expected way, at the expected time, in the expected place.

• These demands are wrapped in protocols, which seem neutral but are already embedded with a metaphysics of presence.

• Those who are disoriented, aphasic, nonverbal, dissociated, chronically fatigued, withdrawn, or stuck in textual worlds — are seen as noncompliant, uncooperative, suspicious, or “difficult.”

So the structural stigma arises not just from what is said, but from the form and expectation of saying itself — the demand for voice-as-evidence.

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II. Textuality and Marginalisation

From here, Derrida’s valorisation of writing (especially différance and spacing) becomes politically salient. Writing is:

• Deferred, indirect, asynchronous, resistant to immediate capture or feedback.

• A model of disorientation — or of existence outside normative temporalities and protocols.

• Often the preferred mode for neurodivergent or otherwise marginalised minds — yet is seen by institutions as suspect, defensive, or pathological.

There is a strange ontological disqualification of text in systems that prize the spoken, spontaneous, the expressive. Text is what you fall back on if you're “not really there.” A crisis form. And so even at the level of interface — the patient interview, the case conference, the tribunal — textual minds are excluded from legibility.

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III. Double Empathy Problem

Damian Milton’s double empathy problem (DEP) reframes the issue:

• It is not that neurodivergent people have impaired empathy, but that there is a reciprocal breakdown in mutual understanding between divergent cognitive styles.

• The dominant system interprets this asymmetry as a deficit in the other — because it cannot perceive its own inability to understand.

• In this light, phonocentrism and presentism are institutionalised double empathy failures, calcified into policies, assessments, and social expectations.

So if someone cannot (or does not) speak in the expected register, the problem is located in them not in the system’s own failure to reach across that divergence.