Neurodiversity Affirming Therapy
Let’s start by defining what Neurodiversity affirming is. There are two elements to this:
neurodiversity
+
affirming
Think about neurodiversity the way you would about biodiversity.
Biodiversity means that there are different animals, plants etc. We need all sorts of different animals and plants for healthy ecosystems.
Neurodiversity means that there are differently wired brains. The uniqueness of each human mind should be included to develop a thriving human society.
The idea of Neurodiversity affirming means that just like we accept and value all aspects of biodiversity, we also accept and value all aspects of neurodiversity. This idea can be applied to all things – from professional services like counselling, GPs or schools, but also how we think and talk about ourselves and to each other.
Specifically in regards to autism – we like to see the use of the word difference rather than disorder or deficit. This is to validate that autistic brains and people are just as good or valuable as neurotypical people.
Having a decific checklist approach leads to dehumanising the Autistic person leaving them as a set of problem behaviours (Prizant, 2015).
Autism is a difference – sometimes it’s even a strength. Even if you think about this from an evolutionary perspective, it makes a lot of sense to have people with different strengths and perspectives when we live in groups. So that we can all contribute in different ways. Taking a neurodiversity affirming approach means that you assume capacity for understanding of the Autistic person (Milton et al., 2022).
Part of being neurodiversity affirming is in the language that we use. For example, not using language such as symptoms & treatments (language we use for diseases)
Instead, in neurodiversity affirming therapy the therapist shows empathy and attempts to understand where the person is in their life, and how they comprehend and experience the world (Prizant, 2015). The therapist tunes into the person, providing co-regulation and support.
I would also like to acknowledge that we are all in different stages of understanding and acceptance of autism. So if you are using different language than here, that is fine – all I am doing is explaining what language and concepts would look like from the ND (neurodiversity) affirming perspective.
Neurodiversity affirming therapy is essential for Autistic adults, because we know that strategies that work for allistics or were invented by allistics to “treat” Autistics at best don’t always work, and at worst are harmful and have serious consequences for Autistics (e.g. ABA). Professionals have a duty to understand the groups of people that they work with so that they can provide appropriate help. History is littered with examples where generalisations have led to cause harm. A classic example of this is what works for men wil works for women, so female presentations of various things from heart attacks to autism are not studied, leading to under/misdiagnosis and harm being caused. Neurodiversity is invisible - and so it can look like we are the same, but underneath we are different and that difference needs to be understood.
The approach that therapy takes is different when it’s ND affirming. For example, by considering the Autistic neurotype from a minority and marginalised perspective (Morgan, 2020), we can take into account issues of oppression and ensure that we are not inadvertently gaslighting Autistic adults. Instead, we can take into account of the implicit power imbalance between Autistic and allistics. This means that we can look at the physical, social, attitudinal, communication and social barriers that exist for Autistic adults.
(Allistics = a neurotype that is not Autistic)
ND affirming therapy also takes into account sensory safety. This may look like developing a sensory profile, and finding ways to incorporate sensory soothers into your day and finding strategies to deal with sensory triggers. This is instead of engaging in sensory exposure therapy, which can actually increase Autistic adults’ sensory sensitivity and distress.
ND affirming therapy also focuses on creating safety in the body. That is, work is done to increase the window of tolerance and to reduce stuckness in fight/flight/freeze states. We understand that Autistic adults have their own mind, and reject the idea that they cannot have theory of mind. and here
Imagine being diagnosed with neurotypicalness...
Being Autistic isn’t the same as being disordered. It is being different - and when how you are is labeled as wrong, that can create many difficulties. I would not want to underestimate that it can be difficult in this world as an Autistic adult. But I also strongly believe that many things can be done to help Autistic adults live the lives they want to (whatever that may look like).
References
Milton, D., Gurbuz, E., & Lopez, B. (2022). The 'double empathy problem': Ten years on. Autism, 26(8), 1901-1903. https://doi.org/10.1177/13623613221129123
Morgan, H. (2019). Connections between sensory sensitivities in autism; the importance of sensory friendly environments for accessibility and increased quality of life for the neurodivergent autistic minority. PSU McNair Scholars Online Journal, 13(1), Article11. https://doi.org/10.15760/mcnair.2019.13.1.11
Prizant, B. M. (2015). Uniquely human : a different way of seeing autism. Simon & Schuster.