What Is Neurodiversity-Affirming Therapy Anyway?
Let’s start with some definitions: neurodiversity and neurodivergence
In order to really understand what neurodiversity-affirming therapy is, we need to understand the terms neurodiversity and neurodivergence. Neurodiversity is a term that was coined by sociologist Judy Singer in 1998, and it encompasses all of the natural variations that can occur within the human brain. Within the neurodiversity framework, folks can be either neurotypical or neurodivergent. Neurodivergence refers to any brain difference from what is typical or expected. While some people use it to refer to ADHD or autism specifically, (sometimes as a euphemism to avoid stigma), the intended usage per Judy Singer was to include any brain difference, from ADHD to traumatic brain injury. A great resource I love referring to is the neurodiversity umbrella infographic created by Sonny J. It really illustrates the wide range of neurodivergent possibilities.
I try to be very intentional with my usage of these words, but let’s be honest, some of that is just my autistic rigidity. Some of it, however, is because when I’m talking about Autistics and ADHDers, I want them to know that I am speaking to a within-group experience that I share as an AuDHDer. While I’ve worked with many people under all different areas of the neurodiversity umbrella, I specialize in individual work with ADHDers and Autistics and mixed-neurotype or neurodiverse couples work, which I’ll talk about more in-depth in another post. Basically, if you’ve got a mix of different communication types because of different neurotypes, I’ve got you covered.
What are the tenets of neurodiversity-affirming therapy?
These next few sections will lay out what the main ideals are behind neurodiversity-affirming therapy, what problems arise when therapy is not affirming, and what neurodiversity-affirming therapy might look like in practice. I’m going to link another helpful Sonny J infographic that describes not affirming (pathology-based) vs affirming practice in an easy-to-digest format that has helped inform this post.
Acceptance over Pathology – Neurodivergence isn’t something to be fixed. It’s simply part of the beautiful diversity of experience that can happen within our brains. When we move away from the pathologizing medical model of therapy, we help each individual find their own shine.
Strength-based Focus – The medical model has a tendency to focus on deficits from a neurotypical lens rather than the strengths inherent to every neurotype, whether neurotypical or neurodivergent. Neurodiversity-affirming therapy works with the client on enhancing their natural strengths, rather than focusing on what can seem like weaknesses in a world designed for neurotypical folks.
Collaboration and Autonomy – Neurodiversity-affirming therapy looks to the individual to set their own goals. The therapist is not the expert. The client is. They decide what goals, milestones, and needs they’re looking to meet. Want to learn to socialize more with your peers? Great, we can work on that. No interest and would prefer instead to work on finding a support system online? Let’s do that instead.
Supportive Adaptations – Trying to survive in a world designed for neurotypicals is rough to say the least. Instead of forcing neurodivergent individuals to adapt to rigid neurotypical norms, neurodiveristy-affirming therapy encourages adaptations and accommodations that allow them to thrive in their own way.
Trauma-Informed Approach – While trying to navigate a neurotypical world, especially if we didn’t realize our neurodivergence early on in life, many of us experienced trauma from unmet expectations, misunderstood social cues, and a whole slew of other issues. Neurodiversity-affirming therapists understand that this trauma is real and needs to be validated and met with compassion rather than dismissed.
Education and Advocacy – Neurodiversity-affirming therapists often educate clients, families, and communities about neurodivergence to foster greater understanding and acceptance. It is our responsibility to help make the world an easier place for neurodivergent folks, one bit of information at a time.
There are risks if therapy is not affirming
One of the main issues with therapy that is not neurodiversity-affirming is the goal of compliance with neurotypical standards. This can include harmful therapy at modifying behavior that might be a method of regulation for the client, such as an Autistic who flaps their hands to self-soothe or an ADHDer who works best in the last second of a deadline. Forcing these clients to give up the ways in which their brain naturally works or their body naturally moves can lead to feelings of shame, unworthiness, and a serious lack of trust in the therapy space.
Another big issue with therapy that is not affirming of the neurodiversity paradigm is the rigid focus on function vs dysfunction. The idea of “functioning” often comes from capitalistic, colonialistic, patriarchal paradigms that only serve to oppress rather than uplift. This way of thinking states that if you don’t or can’t be productive in a capitalistic society, you’re not of use. Ironically, those feelings of uselessness will undoubtedly make you even less productive overall, whether in work or play.
So, what can neurodiversity-affirming therapy look like when it works well?
At its best, neurodiversity-affirming therapy is there to boost the client up and help them get whatever support they need to function with minimal distress and disregulation. Instead of compliance, the focus becomes one of autonomy. The client figures out what they really want to accomplish and the therapist works alongside the client to help make those goals a reality. In this way, I find neurodiversity-affirming therapy to be a lot easier to provide. I’m not here to tell anybody what to do. I’m here to help them figure out what will be best for them. An affirming therapist is there as a sounding board, a collaborator, and a support through rough patches.
And instead of focusing on functioning, neurodiversity-affirming therapy pays attention to support needs. This allows for a wider range of accommodations to be made in the therapy space and beyond, from augmentative and alternative communication (AAC) device use in therapy to how to ask your boss for more flexible start and end times to accommodate when your brain works best. When you have support as your goal, you can really work on meeting your client where they are instead of where society thinks they “should” be.
How does somebody find a neurodiversity-affirming therapist?
One of the best ways to find a neurodiversity-affirming therapist is by looking through a directory. Here are three that I’ve found are really great resources for therapists who are not just affirming of neurodiversity but great at navigating intersectionality in general:
Inclusive Therapists – This directory has therapists who are affirming of all different identities, and you can search by those as well to find the right therapist for you.
Neurodivergent Therapists Directory – This one links up neurodivergent clients with neurodivergent therapists, because sometimes lived experience is the best experience.
Open Path Collective – If you’re looking for something lower-cost, this directory is for you. Great therapists with low sliding-scale slots available post here. Because therapy should be available to everyone who wants it.
There are also a few questions you can ask in your consultation with a potential therapist that will help clarify if they are neurodiversity-affirming. First, you can ask what the phrase “neurodiversity-affirming” means to them. You can also ask about whether they can accommodate any specific support needs you might have in session, such as using AAC or having asynchronous text-based sessions or even just doing virtual sessions with the camera off during really big emotional moments. Lastly, while they might not feel comfortable disclosing, it could be important to you to know what their personal, lived experience is with neurodivergence. Whatever is important to you is worth asking about.
Neurodiversity-affirming therapy marks a shift toward more inclusivity and greater compassion for others. While individualism might seem like a worthwhile goal, taking care of one another is an essential part of the human experience. Affirming the way one another’s brain’s operate naturally is one step toward making the world a kinder, more welcoming space. And you’d be surprised, often when we take care of those of us who need more support, we get more support in return.
