for adult autistics and audhders
I specialize in neurodiversity affirming therapy for high-masking, newly, self, and late-diagnosed autistic adults and those with audhd (autism and adhd). Some of these terms probably have little or no meaning to real people outside of the clinical setting and they’re labels that flag some of my work only in a general way. Frankly, “neurodiverse-affirming” has become such a popular buzzword, that I’ll spell out what that means in this space.
Specifically, I support autistics with nervous system regulation, minority stress, autistic burnout, the disclosure experience, exploration of neurodivergent experience/identity and self-esteem. Though there’s much relief that comes with a diagnosis, many autistics continue to struggle in ways that can benefit from therapy or coaching support.
Centering your "Felt Sense" of Autism
For many autistics, the DSM definition of autism falls short. It doesn’t capture the lived experience of many who self-identify or are formally diagnosed as autistic. Likely reasons are that the DSM criteria did not center autistic voices in the process of categorizing symptoms. Also, the DSM continues to reflect a medical model typically used by psychologists and psychiatrists that categories experiences from an ableist perspective reducing many experiences to their observed behaviors from a neurotypical point of view of “normal.” This can look male, White, Eurocentric and middle aged. The tendency then is to change the behavior or medicate into compliance. For now, we need to add lived autistic perspective to our consideration of whether something merits treatment, support and/or simple understanding.
it can look like many things. what’s the context and what is the internal experience?
What Autism Looks Like
Do You Relate?
Identifying and Supporting Lived Experience
- Falling behind with some responsibilities without being able to employ skills used in other areas
- Living with clutter
- Feeling isolated or experiencing isolation despite having many identified friends or colleagues
- Seemingly contradictory behavior-isolating while craving connection
- Irritability over relatively small disappointments or changes in routine
- Losing track of time in conversations
- Being late despite best efforts and regardless of motivation
- Losing focus
- Prolonging bedtime and sleep despite fatigue
- Sitting in the dark while engaging in activities that require good optics
- Gesturing (a lot) while speaking
- Speaking quickly and loudly while darting from topic to topic and losing your audience
- Feeling like the “third wheel” during social activities or conversation
- Emotional regulation to avoid “autistic burnout.”
- Lapses in hygiene e.g. showering, washing hair.
- Not finishing projects often started in rapid succession
- Daytime naps
What is Neurodiversity?
Trauma-Informed & Supporting Self-Determination, Liberation & Autistic Perspective
The term “neurodiverse affirming,” is used here to highlight my approach to therapy that not only respects divergence as a natural expression of human diversity, but rejects perspectives that are commonplace in dominant psychology, namely, binaries that split us into “us” and “them;” and, deficit-based thinking that promotes negative beliefs regarding potential and restricted ability.
The term is also inclusive and affirming of multi-racial, and BIPOC autistic experiences which are not often supported even within ND affirming spaces. This becomes relevant for issues such as masking, code-switching and survival when Black autistics are much more likely than others to be killed by police, (RIP Elijah Mcclain).
The Need for Strengths Based Affirming Care
We reject binaries that split us into “us” and “them;” and, deficit-based thinking that promotes negative beliefs regarding potential and restricted ability.
Reconsideration of ABA: Often heralded as a gold standard of care for autism and still widely covered by insurance, the very pervasiveness of ABA demonstrates the power of neuronormativity in the mental health field. It also demonstrates the need and context for neurodiversity affirming care. ABA perpetuates social oppression by imposing behavioral techniques that emphasize compliance despite research supporting that it correlates with PTSD in autistics. Many practitioners of ABA are apt to defend that ABA has distanced itself from its oppressive roots, but can they support that its techniques are informed by autistic experience?
Supporting Autistic Identity-Late Diagnoses
While emphasis on empowerment, anti-oppression and liberation supports autistic identity, it also recognizes the importance of improving autistic experiences and quality of life. The process of resistance and redefinition continues.
There are a number of reasons for a late-diagnoses, among which are that autism still baffles many providers who commonly misdiagnose autism with other conditions such as borderline personality disorder and bipolar. (Incidentally, these diagnoses are commonly (and inappropriately?) used to label underlying conditions of trauma or C-PTSD). Arguably, none of them are actually “disorders” as this term often reflects the bias inherent in a world that privileges neurotypical thinking.
How Therapy Helps
Other reasons for a late diagnosis include lack of resources for a childhood diagnosis, and biases that favor diagnosing boys (who are four times more likely to be diagnosed). Many girls, women and people of color are adept at masking and living with pain, social exclusion, shame and confusion which promotes their suffering and delays the relief and liberation that comes from getting ones needs accommodated. For many, self-discovery and curiosity lead the way to self-diagnosis which for many turns into a formal diagnosis. Fortunately, there’s been a cultural shift world-wide from one that viewed autism as a rare condition of childhood that occurs mainly boys, to one that recognizes autism as a lifelong neurodevelopmental divergence occurring in all genders.
Receiving a diagnosis later in life can help adults improve their understanding of themselves in a way that makes sense. It also allows them to take advantage of supports.
Areas of Treatment Focus
- Self-awareness and self-acceptance
- Self-Worth: Social exclusion and decades of masking can embed avoidant behaviors that suppress self-worth.
- Relationships. Autistics are more likely to face victimization. Increased empathy/sensitivity can make autistics more vulnerable to poor romantic choices.
- Sensory hyperreactivity.
- Emotional regulation to avoid “autistic burnout.”