Is a neurodivergence movement finally happening?
Neurodiverse and Neurotypical Clients
Neurodiverse sounds like such a complex term. But it’s quite the opposite. It’s simply an umbrella term which covers Autism, ADHD, ADD, Dyslexia, Dyspraxia, Tourettes and more. We use the term ‘normal’ in different parts of our lives, relationships and families, but we are slowly coming to the realisation there is no ‘normal’ or ‘right’ way for the brain to function.
Following a recent course I wanted to share my thoughts on this topic however I realise this is written more towards fellow counsellors than clients. At the sametime, I hope if you are a potential future client you can gain something useful from this blog as well.
ADHD - Those with attention deficit hyperactivity disorder tend to be judged by the wider population, and can be described as fidgety, always late, disorganised, having trouble focusing, and are lazy. In essence they can actually suffer from excessive brain activity causing restlessness which can lead to issues such as anxiety, depression, sleep issues and forgetting daily habits we take for granted such as eating!
Dyslexics also have their myths. Especially when young they can be described as unable to learn spelling, having sight problems, being lazy, having low intelligence, or having difficulties they will ‘grow out of’. When actually dyslexia is a lifelong condition which involves reading difficulties due to problems identifying speech sounds and learning how these relate to letters and words. There is also a difference in the way the brain processes information, language and symbols.
Autism is a topic I am extremely interested in and have become more and more passionate about, the more I learn. Stereotypes tend to be that an autistic person is someone who exhibits social awkwardness, an obsession with certain topics, difficulty with relationships and reading others facial expressions. These traits can be present, but the more advantageous ones are often forgotten—such as creativity, attention to detail, ability to pick up on patterns or mistakes, strong clarity or focus and they can spot a human lie a mile away! Don’t be anything but genuine, as an autistic person will call you out immediately!
Impairment or Superpower?
Is neurodiversity an impairment or a superpower? See Greta Thunbergs response to Asperger’s critics: “it’s a super power” in the Guardian!
Greta talks about hiding her Asperger’s diagnosis when younger because society viewed it as an illness or something negative. Slowly, however, she began see that being different was something unique and even powerful. She is a young, inspiring individual who is bravely challenging our current society and some of its views.
TV has also a great deal to answer for, our myths and stereotypes- such as Sheldon from the Big Bang Theory, Robert from the A Word, and more recently Sam in Atypical. Quick fun fact—did you know the following were all believed to be autistic or neurodiverse? - Andy Warhol, Vincent Van Gogh, Einstein and Mozart! And for those who are still with us—Chris Packham, Susan Boyle, Dan Akroyd, Courtney Love and Sir Anthony Hopkins.
So, if I still have your interest, you might wonder what it’s like to be neurodiverse?
Diagnosis
From what I understand, diagnosis can be a very complex and challenging process. The NHS can complete a diagnosis, and a private diagnosis (perhaps more in-depth) is also available but clearly more expensive. You can even just self-diagnose. Some people don’t like a label, but others have found a diagnosis empowering and helped them make sense of their lives. Did you know that females, interestingly, are often under diagnosed and recent research shows there is a much higher number of autistic females than previously thought. This may be attributed to the fact that females can be very good at masking their behaviours or mimicking that of others.
Neurodiverse Issues:
Some falling into this category can face a number of difficulties, such as problems with sensory processing, reading facial expressions, prosopagnosia (facial blindness—difficulty recognising someone you know especially in different environments), communication, obsessiveness and comorbidity. Co-morbidity simply means more than one illness or disease occurring in one person at the same time. These have been known to be things like eating disorders, anxiety, depression, self-harm etc.
In therapy….
I feel one of the biggest challenges for a counsellor is that neurodiverse clients can often be high risk clients. In the British Journal of Psychiatry, it was noted the suicide risk of autistic people was 10 times higher than in the general population (Nov 2015). It is therefore so important to keep checking in on their safety, no matter how well you feel counselling may be going. Therapy can help most by finding out what your client’s goals are e.g., improving social skills, making peace with themselves, having someone understand their extremely busy brain or to just listen. It might be to work on their self-esteem, anxiety or depression. I have found it helpful to ensure I am working on what they want, and not what my inner self may be drawn towards helping. Therapy can always help, but recognising a client’s comfort zones can be equally important. Sometimes being mildly autistic can be worse than severely autistic in the sense that the former may not have had a diagnosis or received the help they needed. Always do what we as counsellors are trained to do - step into their world and consider it from their point of view.
Dos and Don’ts
When attending a recent course, I was reminded of the dos and don’ts. Be clear in what you are trying to say, avoid the use of metaphors, consider your environment (strong smells, lighting etc) Do offer any strategies you think might be helpful. Do offer a break in the middle of a session. Do be patient, let the trust in the relationship build slowly if it needs to. Explain the therapeutic process clearly and stick to time boundaries.
Don’t worry about stimming (any kind of self- soothing behaviours) dress or habits. Don’t make any assumptions and don’t pretend to understand if you don’t - just ask. Don’t say “we’re all on the spectrum somewhere”, or “you don’t look autistic”. Don’t worry it doesn’t feel like therapy (this point I liked, and set my mind at ease!) So, for example if the client loves penguins (yes, I’m stealing Sam’s obsession from Atypical) then allow them to speak as much as they wish about Penguins! Maybe you are the only person in the world who will listen with patience. Don’t be shocked if they have a police record either - they may have - but it can often be the result of miscommunication or misunderstanding.
In Summary
I have learnt as a therapist that the key is to be flexible. Let those rules we normally strictly adhere to and have been drilled into us, loosen a little. Let the client sit at an angle not directly facing you, offer up your figit toys, accept their own self soothing behaviours. The facial cues that we so often look out for, may not be there, and they may struggle to read ours. Small talk on arrival may not be welcomed and seen as irrelevant. Don’t be rigid, especially with attendance. Be clear about certain boundaries and they will appreciate and respect them. Don’t do the ‘hints’ thing as they may not pick up on this. Everyone on the spectrum is an individual and deserves an individual approach in therapy. Don’t worry about not having that all important eye contact as they may well find this hard. Let it be difficult for us for once! Be careful with that space and silence- it may be that this is very uncomfortable for them so check in with them to see how they feel about it.
Reflecting back to my recent course, one thing said which really resonated was that it’s not the neurodiverse person who needs to change, but society’s attitude towards them! Also, good supervision is essential as is the supervisor’s knowledge on this topic. Finally, and I'm sure if you are a counsellor you are already doing this, but be you, the real and genuine you —they will know if you’re not!