April is Autism Acceptance Month so I wanted to say something about neurotypical therapists working with neurodivergent clients⏤as someone who is autistic, a therapist, and very frequently a client too.
This can be a relationship that functions well, but learning to relate involves more than acquiring information. Neurotypical therapists will need to do a lot of personal work around understanding structures of power and their position within them. So while I would encourage taking training (provided that training is delivered by neurodivergent people) what I want to emphasise is that it is that often uncomfortable personal work done by the therapist which is key.
Neurodivergent people⏤autistics, ADHDers, and others⏤often struggle with neurotypical systems, which can impact our daily lives, relationships, and mental health. Therefore, we need good therapists who understand us.
It’s common for neurotypical therapists to feel that neurodivergent (particularly autistic) people are fundamentally different from them, not just different in parts. The therapist won’t know this (probably) and won’t like hearing this (usually) and will be doing their best to be accepting and kind. What this leads to is an othering of the client⏤to the therapist seeing the client as a problem that needs fixing⏤and the client feeling a kind of diminishment they often can’t quite put their finger on. Neurodivergence is a natural variation in human functioning. Therapists need to realise the ways in which neurotypical practices are centred when we consider what ‘functioning’ really means.
It is important to avoid pathologising normal neurdivergent ways of being⏤special interests aren’t obsessions, avoiding social situations isn’t social phobia, dysregulation isn’t the result of faulty thinking or behaviour. The goals for therapy might look different when you’re working with a neurodivergent person. What ‘good functioning’ means should be defined by them, not you. Genuine empathy means to see the world as your client sees it. Be mindful of the double empathy problem. And never underestimate a neurodivergent client.
Neurodivergence is the ground where experiences land, it is the wiring: therapists often ask how they can differentiate between what is neurology and what is trauma as they can look similar in affect⏤the truth is that neurodivergent people experience trauma and abuse and disaffection in the same way as anybody does, but we may register and process it a little differently, that’s all. And when a neurodivergent person says something hurts you should believe them, even if it’s not something that hurts you.
Alexithymia refers to difficulty in identifying and describing emotions, which can make it challenging us to process what we’re feeling and communicate with others.This can be frustrating for both the individual and their therapist, as it can make it difficult to develop shared understandings. Therapists may need to use more flexible and creative approaches, incorporating sensory and movement-based interventions, and be mindful that a little abstraction when dealing with feelings is OK and doesn’t mean that the therapeutic work isn’t happening.
Finally, it’s worth noting that many neurodivergent people are gender-fluid, transgender and Queer. If you are not fully LGBTQ+ positive and gender-affirming, you should never work with an autistic client. No amount of training will make up the ground if you are not fully honest with yourself about how genuinely comfortable and accepting you feel. Again, this might be difficult to acknowledge⏤but hey, growth is hard.
You can find a neurodivergent therapist in the UK by clicking the link below.https://neurodivergenttherapists.com/: On Neurotypical Therapists Working With Neurodivergent Clients
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