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Surviving Therapy as a Neurodivergent Person

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***This is an update to the blog post "Surviving Therapy as a Highly Sensitive Person" from 2022. I have learned a lot since then and felt the need to provide more updated information. At that time I was just becoming familiar with the term 'Neurodivergent' and how being a Highly Sensitive Person (HSP) places you under that umbrella. Since that post, I have become very aware of Autism and ADHD and how these can be mislabeled or totally overlooked when we're only focused on the trait of HSP. After reviewing the old post, I recognized how much of the information applies to the broader umbrella of Neurodivergence, yet important changes needed to be made. I have updated language throughout the post to reflect Neurodivergence and have changed or added other imformation to better emcompass the broader Neurodivergent experience. Because many things fall under this umbrella, it is actually quite hard to represent all experiences. This highlights some of the most common features my clients and I experience.


How to get the most out of therapy when you're Neurodivergent

As a Neurodivergent person you have unique needs, strengths, and ways of processing. There are many barriers to getting your needs met and your strengths seen by others. Although more likely to be seen for who you are in therapy, this barrier does still exist. Unless your therapist is Neurodivergent themself, has studied Neurodivergence in-depth, or is in a close relationship with someone who is Neurodivergent, they likely don't get the nuances of who you are and why you operate as you do.

The good news is, there are many Neurodivergent therapists out there. The downside is many therapists do not have the understanding or lived experience to support Neurodivergent clients in an affirming way.

So how do you find one of these Neurodivergent therapists?

Maybe like me, they have it posted on their website and are seeking to support other Neurodivergent humans. This is becoming more common, but still not the norm. And even if it is, what are the odds it will show up in your internet search? Here are things you can do to help find a Neurodivergent therapist.

  • You could ask your current or potential therapist directly if they are Neurodivergent and what their knowledge and experience is with being Neurodivergent affirming.

  • You could type into your internet search engine, "Neurodivergent therapist" or "therapist for Neurodivergence."

  • You could search the Neurodivergent Therapist Directory.

Now, what if you can't find a Neurodivergent therapist?

Or maybe you already have a therapist who isn't Neurodivergent, but you really like them. It can still work, and here are some tips to help your therapy experience feel affirming.

  1. You can search for a therapist who meets the qualities below.

  2. You can give this list to your current therapist so they know how to make therapy more fulfilling and effective.

(Not everything on this list will be for you. Consider highlighting the qualities which are most important, crossing out the ones which don't apply, and making notes beside any to better explain your needs and preferences.)


cozy library in front of window

The Environment

Neurodivergent humans are often sensitive to their environment. This means they are picking up on the energy of the environment, the cleanliness, the lighting, the comfort, the noise, the aesthetics, anything out of place, and plenty more.

The ideal environment for me has soft lamp lighting, calming art work, plants, low noise levels, no harsh or chemical smells, a window, things to fidget with or ways to move around, and is clean and free of clutter. It's also comfy and not stuffy.

What's the ideal environment for you? Consider your sensory needs and what helps you to feel most comfortable. You might decide to find a therapist who has your ideal environment as their office, or you might decide that your environment is the best and so telehealth is the way to go. Whatever it is, for the environment to work, you will feel comfortable and have the adequate amount of stimulation.

person looking out window

The Processing

Neurodivergent humans, particularly Autistic, ADHD, and HSPs, have a greater depth of processing. They often think deeply and have a very involved inner world. This can impact therapy in different ways.

1) It may take longer to process (or even recognize) your emotions and new information coming in. During a session, there may need to be longer pauses as you think something through. You may also need to come back to a topic during a future session to give more space for processing on your own.

2) Once something has been processed, it is often on a deep and thorough level This means you may start to progress quickly in particular areas. You may also find that the thoroughness of your mind and nervous system leads to overwhelm and flooding during the process. Your therapist will need to know how to slow things down and help with processing and regulation.

laptop on desk in office

The Diagnosing

There are a couple of points here. 1) There is a lot of mis and missed diagnoses among Neurodivergent people. Their nervous system sensitivities, differences in processing, differences in communication, and much more are often over pathologized and/or misunderstood. 2) Because of the above and because of the overwhelming and unaccommodating world we live in, Neurodivergent individuals are more at risk of developing depression, anxiety, substance use, being traumatized, and other mental health concerns.

1) What I've noticed and experienced is that when Neurodivergent folks are chronically overstimulated and stretched thin, anxiety, depression, mood swings, sleep problems, harmful coping strategies, burnout, and much more will emerge or get worse. Once they start to find understanding, accommodations, life balance, and adequate self-care, many, if not all of the above will improve. Be aware that if your therapist is not knowledgable on Neurodivergence and the impact of living in an overwhelming world, they may only see your experience through a lens of mental health disorders and you may walk away with a long list of diagnoses. Let me assure you, although there are diagnoses under the Neurodivergent umbrella, to be Neurodivergent is not a diagnosis in itself, but rather a difference in brain wiring, often from birth.

2) The other side to this is that Neurodivergent folks are actually at greater risk for developing mental health problems. This is because being Neurodivergent often makes you greatly impacted by your environment. If your environment is poor and invalidates or neglects your differences and needs, you will experience a greater negative impact than Neurotypicals. As a results you may develop complex trauma, anxiety, depression, substance use problems, or more. And FYI, this also means if your environment is positive and supportive, you can thrive and grow in your Neurodivergence.

animal standing in front of door

The Boundaries

Boundaries can be difficult if you're Neurodivergent. Whether it's nature or a learned protective strategy (fawning), many Neurodivergent people have high empathy and are conscientious. They may fall into "people-pleasing" and are more likely to focus on others' needs, rather than their own. This can also happen because of alexithymia and interoception difference, where there is a disconnection between feelings, awareness of feelings, and the ability to understand and communicate the feelings.

If you are Neurodivergent, you've likely heard you're "too sensitive" or overreacting. With this repeat message, it becomes difficult to listen to and trust yourself. This may mean you do not recognize your limits, wants, and needs, and therefore are not able to communicate or enforce a boundary.

Here's how this becomes a problem in therapy. A Neurodivergent person may want to please their therapist or make sure the therapist is comfortable by not causing conflict or 'ruffling feathers.' The current treatment strategies may not be helpful or make sense, yet the Neurodivergent person does not speak up. Often this happens without real thought, it's just the automatic response that has been learned over the years. We might view it as a "mask" the Neurodivergent person has had to wear. If this is your dynamic and your therapist is unaware, this is a problem. As a client, your role is to show up just as you are. No, your therapist cannot read your mind, however a therapist who is aware of and understands these patterns will be more effective in better meeting your needs rather than vice versa. It can be helpful to find a therapist who will not accept your efforts at making things easier for them, but will instead make things easier for you. Examples of this could be meeting your needs around scheduling, lighting, or other environmental factors, using other strategies to help you understand and communicate your inner world, and being open to continuous feedback.

two animals sitting beside each other in cozy home

The Understanding

I find this to be one of the most important aspects on this list. In my experience, a huge part of healing as a Neurodivergent human is feeling truly understood by someone. Being chronically misunderstood is one of the most common sources of wounding I hear from my Neurodivergent clients. Having a therapist who gets this and does not add to the pain of being misunderstood is essential. Find a therapist who understands and accepts you and helps you to understand and accept yourself.

animal swimming in water

The Depth

A common trait of Neurodivergence is a difference in processing. This often shows up as having a vast inner world and thoroughly processing information. Many Neurodivergent folks seek depth, especially in the things they value. This is often true in the types of relationships and the topics of conversation that are craved. The struggle can sometimes lie in the space of anxiety, being slow to warm up, not feeling clear about social expectations, and overstimulation from the environment. These can all get in the way of opening up, being vulnerable, and going deep with others. This likely will not last forever, but can impact the therapeutic relationship and progress. Many Neurodivergent folks need time to adjust to the environment, process the many elements of the experience, understand the expectations, and develop comfort before moving deeper into the relationship. They need to know they will be safe. There is often a lot of relational hurt and trauma, so trust and openness is not given freely.

Staying in the place of 'shallow waters' will not lend to much healing and progress. Having a therapist who can gently move you into a comfortable and safe space, where you can experience depth is helpful. There are specific tools a therapist will have to help facilitate this. Not every therapist will have these skills or will practice in this way.

On a side note, small talk for many Neurodivergent folks is literally painful. It's often helpful to skip over the small talk and move right into what's important. Is your therapist able to move past the small talk / surface material and take you into deeper material? And, (this is super important), can your therapist take you there in a safe and well paced way?

cozy town in a globe

The Modality

To tie all of the above together, there are certain therapeutic modalities and tools which may be a better fit for the Neurodivergent brain and experience. This is not an exclusive list and the most helpful or relevant modality for you may change over time. Therapeutic modalities and strategies that help with trauma processing, body and emotional awareness, self-acceptance, sensory needs, relational distress, burnout and chronic health problems are often useful for supporting Neurodivergent humans. Here are some modalities and strategies to consider:

  • Internal Family Systems (IFS) or other 'parts' work

  • Mindfulness

  • Self-Compassion

  • Emotion Focused Therapy (EFT)

  • Eye Movement Desensitization and Reprocessing (EMDR)

  • Acceptance and Commitment Therapy (ACT)

  • Sensory focused skills

  • Occupational Therapy

  • Distress Tolerance, Emotion Regulation, and Relationship skills

If you would like to start therapy or have questions, please reach out here and consider subscribing to the mailing list for periodic updates and relevant resources.

Take care and be well!

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