How Neurodiversity-Informed Counselling Can Help

 

My style of counselling draws mostly from the Person-Centred Approach, a way of counselling first invented by psychologist Carl Rogers in the 1960s. This is an approach which assumes you, the client, are the expert on your own life, and that inside you, you already have everything you need to be a fulfilled, self-accepting person. Underneath all of your difficulties and struggles, your true, authentic self and all of your potential is still there, waiting to be discovered. You just need the right environment for it to show itself.

• Difficulty identifying emotions (sometimes called Alexithymia)
• Disliking eye-contact
• Lack of facial expression (sometimes called 'blunt affect')
• Atypical body language e.g. looking angry when stressed, looking bored when concentrating, fidgeting even when not anxious etc
• Need for very detailed, precise instructions
• Very literal way of communicating
• Sensory overload and sensory distractions
• Cognitive 'inertia' - difficulty starting, stopping or changing direction on a task
• Low self-esteem (from having differences seen as faults)
• Social anxiety (making getting to know a counsellor quite scary)

So as your counsellor, I'm not going to tell you what to do. I'm sure you've already had plenty of advice: If it worked, you wouldn't feel the need to consider counselling. What I can do is listen - without judgement and work with you to figure out your thoughts and feelings and separate the 'shoulds' from the 'what is'.

Well so far, I've described Person-Centred counselling. How does that differ when you're an autistic person, Aspergers, ADHD or other Neurodivergences (ND)?

In a way, it doesn't. Every neurodivergent person is an individual, and we are all unique. But there are particular difficulties autistic and other ND people commonly experience. The most common of which is that we are different to most of the people around us. Yes, we are all different, but some of us are more different than others. And being different often means we are frequently misunderstood and may have a lot of negative experiences, leading to us trying to 'mask' or cover up our ND traits to better fit in. After many years, that masking becomes more and more automatic, and we can lose our sense of who we really are, underneath the mask.

In the old days of the Neurodiversity movement (as it's now called), autistic people used to gather on the internet (Usenet Newsgroups). We used to refer to one another as 'ACs', meaning 'Autistics and cousins'. The 'cousins' sometimes referred to other neurodivergent individuals (those with ADHD, Tourettes, dyslexia etc), but generally we referred to each other as 'cousins'. There was a kind of invisible bond between us. Not that we were the same, but like distant cousins in a real family, we had enough in common to recognise one another's struggles.

I still sense that bond to this day. It can be a joy when talking to a stranger at a conference or whatever, and you are both struggling with a similar problem e.g. the lack of literal language in the conference leaflet, sensory overload in the conference hall, embarrassment about fidgeting ('stimming' we call it in the ND world) or tics. Having a counsellor who is neurodivergent can be a great relief when you don't have to explain or justify why you find certain things hard. And even if I don't have that problem personally, you can bet your bottom dollar that I know someone who does, a friend or a relative!

So, here's a list of some of the common issues we have to adapt to, when counselling a neurodivergent person:

Some of this is because of autism and/or ADHD - but a lot of this is because people have a lot of trauma from how they've been treated, because of being ND and different. Sometimes that trauma is from people with the best of intentions - teachers, parents, previous therapists etc. So as your counsellor, I try to take all of this on board: not making assumptions but bearing in mind what sorts of things I might learn about you and being prepared to adapt my approach to meet your needs.

For example, a client might have a lot of difficulty knowing what sort of things to talk about in a counselling session. That's OK - my former tutor used to say, 'Something will emerge'. 

She's right - it usually does. And the thing you first think of is often a good place to begin. But it's hard when you're an ND person who is always careful to try to say the 'right' things and you are afraid of judgement. But I will occasionally adapt my approach by suggesting a place to start. Once we're off, we're off!

Another example is a very socially anxious client who may be scared to meet the counsellor (even over Zoom). So, adapting my practice to allow a trusted friend or relative to be there for the introduction can help.

As for things like facial expression and atypical body language - the key here is knowing that each individual may have different expressions and body language, but I just have to get to know you, and learn how you show your feelings, and we're fine.

Mostly, counselling ND individuals is about accepting difference and believing in my clients. Which, ironically, is how I work with everybody - ND or Neurotypical (ie Muggle).