Search Results

Embracing Neurodivergence: Moving Beyond Binary Cognition Neurodiversity as term was created to move away from the idea that cognition is rooted in a binary of normal vs. abnormal. Categorizing things as normal vs. abnormal or good vs. bad, creates an othering effect where one category is the standard and anything that fails to meet that standard is not deemed as not worthy. Neurodivergence (ADHD, autism, developmental disabilities, OCD, ABI, Tourette's) are just divergences of the normal human mind. Under the medical model, anything that strays away from the norm is categorized as a disorder, disease or dysfunction. The medical model concerns itself with things that need to be fixed or cured. The problem with viewing neurodiversity under the medical model is that it pathologizes the neurodiverse human experience. This frames neurodiversity as a deficit within the individual and the treatment approach is symptom elimination and whatever society deems as normative functioning. In a capitalistic society it can be assumed that normative functioning is associated productivity and wealth generation. From the disability rights movement, came the neurodiversity movement which focused on cognition. The disability rights movement fought to move disability from the medical model to the social model. The social model of disability moves the focus from the individual to society, it shifts the focus from the person to the environment, which means it also shifts the onus. The social model of disability posits that society should change to accommodate to the needs of its people. The neurodiversity movement aims to normalize the experiences of neurodiverse people and promote acceptance for the different ways people may experience the world. Neurodiversity affirming care aims to provide non-pathologizing approaches when providing care to neurodiverse people. With a neurodivergent affirming care approach, the focus is not symptom reduction but on acceptance and support. Why is it needed? Traditional therapeutic techniques were not developed for the neurodiverse mind. This is important because there is a huge need, and not enough clinicians trained in neurodiversity. Individuals with autism have higher rates of co-morbid psychiatric diagnosis than the general public (anxiety and depression were also tripled) , as well as higher premature mortality rates (the rate was even higher for those diagnosed with an intellectual disability), and higher death due to suicide rate. While it is noted within the research that CBT has shown success in supporting people with autism, it can also be noted that clinicians are hesitant to adapt the therapeutic model. It is also important to note that autistic people’s experiences with the medical system are often traumatizing and alienating due to medical professionals not truly understanding autistic differences. ABA (applied behavioural analysis) is the first line of treatment for children with autism, critics of ABA say it is designed to train the autism out of the child. While small conversations about neurodivergent affirming care are happening, it is still not very common in clinical practice yet. There are many reasons for this, but I think a big one is because much of the funding for research in this area is dedicated to the biological mechanisms of autism, rather than understanding the needs of autistic/neurodiverse people. In addition, much of the research surrounding autism is focuses on children rather than adults. Supporting Cognitive Diversity in Therapy Neurodivergent affirming care is about making space for all, so how can this be accomplished in terms of your clinical practice? Reconceptualize dysfunction as relative rather than the individual When actively listening to a client, listen to understand. A neurotypical might not inherently understand the neurodiverse experience, but you can learn and you can empathize. Dr. Darren Milton coined the term the double empathy problem. “when people with very different experiences of the world interact with one another, they will struggle to empathize with each other, and this is likely to be exacerbated through differences in language use and comprehension”  (Milton, 2018) Normally the burden is on the neurodiverse person, to adjust their communication style. When providing neurodivergent affirming care in therapy, it will be only natural that there may be a communication breakdown. Be open to employing some flexibility in your practice. Try different communication methods:  watch out for broad questions, visualizations and metaphors, reviewing a topic as many times as needed, Don’t assume  that something related to their neurodivergence is an issue. Learn how to support with executive dysfunction disorders. Ask for feedback , acknowledge any invalidations Educate yourself  on the profound impact that sensory input has on a person’s life The findings of a research study with 111 autistic individuals revealed that the internalization of discrimination and marginalization, was a large proportion of both well-being and psychological distress scores. Once an individual gets to a place where they are ready to process the internalized shame they live with as a result of discrimination and marginalization, barriers such as communicative practices or sensory environments of therapeutic setting were viewed as non-compliance. In short, they were labelled as not participating in their own care, which affected the relationship with their therapist (Chapman and Botha, 2022). Validate their experiences,  acknowledge internalized ableism and shame, and provide support. Challenge negative beliefs  by helping clients identify and counter harmful stereotypes about neurodiversity. Promoting self-acceptance,  encouraging clients to embrace their unique strengths and perspectives. While neurodiversity and disability are often used interchangeably, they are not synonymous. Neurodiversity refers to the natural variation in human brains, encompassing differences in thinking, learning, and processing information. Disability refers to a physical or mental impairment that limits a person's ability to function in the world. Some neurodiverse individuals may also experience disabilities, and not all people with disabilities are neurodivergent. Depending who you ask, they might define their neurodivergence as a disability due to how debilitating it may be however, its 2024 and we need to normalize the fact that people need support in whatever way is meaningful to them. Needing support is not unique to having a disability, the support needs of a neurotypical person might look different than the support needs of a neurodiverse person. Incorporate the client’s interests and passions  into supports and create therapeutic tools that appeal to them Supporting with executive dysfunction and burnout prevention,  as the world is not very accommodating to anyone who is different, neurodiverse people are sometimes great maskers. Support your client to ditch socially acceptable rules and tools that were created by neurotypicals as they manage their executive dysfunction and burnout. Support to help regulate nervous system and emotions , masking requires one to suppress their internal world that dictates their communications and actions. In suppressing their internalize world, they are also suppressing their natural emotional reactions which can be dysregulating and create anxiety. While some mask, those who are unable to may have difficulty controlling their emotions and understanding where they came from. Psychoeducation around the nervous system, the alarm signs our body gives up and coming up with a plan for those tough moments. Does it work for neurotypicals? The answer is yes! While neurodivergent affirming care was initially developed for neurodiverse individuals, its principles can be applied to benefit anyone, regardless of neurotype. Many of the core principles, such as empathy, understanding, and individualized approaches, can be applied to therapy for anyone. As a clinician using a framework of neurodivergent affirming with neurotypicals can help you understand the client’s unique perspective  even if it differs from your own With a neurotypical population using a neurodivergent affirming framework that is focused on strengths can help challenge negative beliefs about their abilities or self worth . Especially if the individual does not fit into what our society deems as normative functioning. Conversations with neurotypicals surrounding their negative beliefs can lead to increased confidence and foster building positive self worth. Burnout is a common experience, but neurodivergent individuals often face unique challenges related to sensory processing and environmental factors. Neurodivergent-affirming care can help anyone identify and manage burnout  triggers, build resilience to life’s hardships, and create sustainable routines. Final Insights: Advancing Neurodivergent-Affirming Practices Supporting cognitive diversity in therapy signifies a transformative change in our perception of cognitive differences, shifting away from a binary viewpoint that classifies individuals as either normal or abnormal. By promoting neurodivergent affirming care, we not only improve the well-being of those who identify as neurodiverse but also enhance the therapeutic environment for everyone, including neurotypicals. This method cultivates empathy, fosters acceptance, and encourages a more inclusive society that appreciates varied cognitive experiences. As we persist in challenging conventional models and prioritizing neurodiversity, we create a future where all individuals can flourish, empowered by their distinct cognitive profiles. Ultimately, supporting cognitive diversity is not merely essential for a more just world; it is an opportunity to celebrate the diverse fabric of human cognition.