What Exactly Does it Mean to be a Neurodivergent-Affirming Therapist?

Being a neurodivergent-affirming therapist involves many aspects, but first and foremost it means forsaking the idea that there is something "wrong" with neurodivergent brains and embracing the awesome and endless variety of how human minds work (aka, the neurodiversity paradigm).

The neurodiversity movement seeks to dismantle the idea that there's a "normal" way for brains to work (neuro-normativity), much like the queer movement seeks to dismantle the notion that being cisgender and straight is the only "normal" way for gender and sexuality to work (cis-heteronormativity). Although the Diagnostic and Statistical manual 5 TR may imply otherwise, being neurodivergent doesn't mean you have a broken brain that needs fixing. It's just a different way of experiencing the world.

What Does It Mean to Be Neurodivergent?

Think about it: we are all different in so many ways, right? Well, our brains are just as diverse. There are many varying experiences that fall under the neurodivergence "umbrella" with one commonality being having a brain that is wired a bit differently from what western society and culture usually expects. Some folks are born this way, others become this way through an experience or set of experiences that alter(s) their brain, and for some, it's a mix of both.

Examples of neurodivergent experiences range fro not only ADHD and Autism but also Bipolar, Dyslexia, PTSD, OCD etc. It is common for folx to have co-occurring neurodivergent experiences as well as potential physical manifestations of neurodivergence as well.

Prioritizing Lived Experiences of Neurodivergent Folx

 While neurodivergent-affirming therapists will be sure to spend time validating and processing with clients the challenges of living and functioning within a society that is not in many ways built for them, neurodivergent-affirming therapists will also look to highlight the unique strengths of their neurodivergent clients, and treat them like the expert of their own life experiences (because they are).

While it's crucial for neurodivergent-affirming therapists to understand common neurodivergent experiences so that clients are not tasked with educating their therapist on the basics, working with the vast array of neurodivergent experiences is not well-suited for a one-size-fits-all approach.

Despite the topic of neurodivergence being a hot topic in research studies recently, what we understand about neurodivergence via the data seems to paint a limited picture in comparison to what we are learning from the increasing number of people identifying and discussing their unique neurodivergent experiences in the real world.

Moving from a focus on evidence-based practices to a lived experience informed model as a foundation in the work prioritizes the diverse voices of those who are neurodivergent and are actually living these experiences as opposed to prioritizing the current limited research. That is not at all to say that research is ignored, but the individual’s intersectional experiences heavily influence the work in the therapy space. The idea here is the prioritization of dynamic neurodivergent individuals and adjusting prior knowledge to best support the client without being constrained by a rigid evidence-based approach.

Reimagining Therapeutic Communication

Being neurodivergent in a world where neurotypical standards are heavily enforced can be tough, draining, and traumatic.

Providing neurodivergent-affirming care creates a space where clients can just be themselves - no masks, no pretending; just the opportunity to get to better know and accept their authentic selves outside of the pathologizing capitalistic world we live in.

Unfortunately, in most spaces, the responsibility of identifying and requesting accommodations almost always falls upon neurodivergent people to figure out, which can be a whole lot of pressure. Through using something called the universal design principles, therapists can reduce this burden by providing clients with multiple means of engaging and expressing themselves within the therapeutic space.

What does that look like? Well, it starts with giving clients options. Beginning in the consultation stage, therapists can (when possible) provide clients with multiple options for connecting as they best meet the client’s needs (such as video, phone call, or in-person).

Additionally, therapists can provide the client with options to share ideas via other means beyond verbal such as through writing, art, or music, that can then be reviewed together in session. This can be a game-changer in taking the pressure off of clients who struggle with memory and/or find it easier to organize and express their thoughts and feelings via writing or art. The same idea can be applied with clients and therapists exchanging information via different mediums such as videos, podcasts, articles, social media posts, etc. The point is to create an opportunity for the client to share and receive ideas in the ways that actually work for their brain. 

Serving Neurodivergent Clients

Below are some basic considerations that neurodivergent-affirming therapists utilize. The list is not exhaustive:

• When doing research, we make sure to notice the language used by the community. For example, knowing the difference between neurodivergence and neurodiversity or avoiding pathologizing language that focuses on disorders and dysfunctions. Therapists can break down the stigma of neurodivergence by not shying away from words like “autism” or “autistic” as they are not inherently bad or derogatory terms.

• Understanding the systems that perpetuate neuro-normativity and discrimination against neurodivergent folx. Capitalism is a major proponent of neuro-normativity in that it places the highest value on those who can conform and perform within its strict rules and expectations. So much of the neurodivergent experience is living in a world that was not made for your brain and it’s important that as therapists, we understand the insidiousness of capitalism which continues to pose barriers and perpetuates oppression. Neurodivergent folx, whether they were diagnosed as a child or not, have likely either been explicitly or implicitly told to change and conform to the environment around them. The social justice perspective provides an alternative view that recognizes the need for societal change and that asking neurodivergent folx to mask (i.e. pretend to be different than they are) their entire lives is not the answer. 

• Awareness that not all go-to therapeutic techniques will be the right fit for neurodivergent clients. Neurodivergent folx may struggle with interoception and recognizing/identifying internal bodily cues; so we can work to find other ways to describe emotions and bodily experiences. Differences in attention can impact experiences with meditation but mindfulness can be achieved in many other accessible ways whether the client is sensory-seeking, sensory-avoiding, or a mixture of these. Getting creative and going back to the basics can be very effective with folx who may have never been given the tools to regulate their emotions in a way that feels good for them. Having a therapist share their relational experiences of a client with the client can help that client understand how they are experienced by others within social interactions; an opportunity they may not have had before.

• We assume competence of clients and understand that certain behaviors may not be intentional or indicative of a larger problem. If a client is late or misses a session, they may have just forgotten or lost track of time due to time blindness. This does not mean that therapists discard their practice policies, but understanding a genuine oversight versus a lack of respect for therapy time is important. 

• Encouraging natural behaviors and unmasking with neurodivergent clients. As mentioned numerous times already, neurodivergent-affirming care can be a space where clients can attune to their own natural behaviors and social responses within the therapeutic relationship. This could look like stimming, not making continuous eye contact, using fidget tools, moving around, etc. We do not reinforce the rigid social expectations and structures that can be harmful and oppressive to neurodivergent folx. Providing a space for clients to explore what feels soothing and safe for them and permission to bring forth their full authentic selves can be healing in itself. Therapists can model this for clients through bringing their own authenticity to the therapeutic space.

In Summary:

Being a neurodivergent-affirming therapist is about embracing the beautiful diversity of human minds and creating a safe, accepting space for clients to be their authentic selves. It's about moving beyond outdated, one-size-fits-all approaches and instead focusing on each individual's unique experiences and strengths. By using universal design principles, staying informed about neurodivergent experiences, and challenging societal norms, therapists can provide more effective, empowering care. Ultimately, neurodivergent-affirming therapy isn't just about helping clients cope with a neurotypical world – it's about celebrating neurodiversity and working towards a more inclusive society where all types of minds are valued and supported.