Below file is a recording of this blog
Throughout this website I write that I work in a neuro-affirming way but what exactly does that mean?
One of the first things you might have noticed is that I don't use the word 'diagnosis' but 'identification' or 'realisation' (I tend to use 'identification' when I'm referring to someone else confirming your autism and 'realisation' when you've come to realise on your own that you're autistic, also known as 'self-diagnosis'). The reason for this is that autism is currently assessed using either the DSM (Diagnostic Manual of Mental Health Disorders) or the ICD (International Classification of Diseases) and autism is neither a mental health disorder or a disease. And the word diagnosis is a medical term for when something has been identified as 'wrong' or 'defective' about someone, like diagnosing cancer. Autism isn't a deficit but a difference in neurotype. That's also why I work with an organisation that identifies autistic people based on their strengths and not their neurotypically perceived weaknesses (the deficit model).
The neuro-affirmative model looks at what's right about you, not what's wrong with you.
It's about unlearning harmful ways of thinking about yourself including internalised ableism, or stigma/shame and addressing the language we use.
For example, instead of 'hyper-focus' I say 'passion'. Instead of the calling autistic people 'slow processors' I see them as 'deep and thorough processors'. Instead of stimming, I say 'regulation behaviours'.
I'm not the language police and you're allowed to use whatever vocabulary and identifying markers you prefer. And, for example, there's nothing wrong with the word 'stimming' but it's just that stimming is an emotional regulatory behaviour and every single human being emotionally regulates throughout the day but because autistic people do it in a 'strange' way according to neuromajority, it gets a different name, adding to the 'them' vs 'us' narrative and the 'othering' of autistic people.
The neuro-affirmative way is about de-pathologizing autistic people. So instead of viewing the rich and wonderful ways that autistic people socialise and communicate as a deficit, because it's not how neurotypicals do it, the neuro-affirmative approach sees it for its own unique and valid way of being.
When it comes to the world of mental health what's considered 'right' or 'wrong' is based on who has the power. The same goes for neurotypes and other minority groups.
Similarly, post-diagnosis support (as in support offered by the medical profession or clinical staff) is often focused on what's wrong with the person in front of them and how to treat/cure/fix them.
My approach is to not assume there's anything 'wrong' simply because you're looking for support. I'm a big fan of and believer in everyone having therapy or coaching to simply explore one's own mind, engage in active reflection and improving oneself and one's life. However, if someone is struggling then my approach is to look at what has happened to them to shape the unhelpful beliefs they might have or the struggles they're facing and through compassionate inquiry finding their strengths and learning how to promote self-advocacy. It's all about empowering a person, not disempowering them.
But the neuro-affirmative approach goes beyond language. It's also to allow a person to show up to sessions as they need and are able to. Many neurodivergent people focus better when in movement or when doing something with their hands. It's anxiety-inducing to see a therapists so, of course, therapists should encourage the people they're working with to self-sooth and use comfort blankets or support animals or to have the camera off, or if meeting in person, to move a chair to where they want and have freedom in where they want to sit and in which direction (also referred to as decolonizing therapy - another example of how therapy is political when certain therapists insist on deciding what a client can and can't do in a session if it's not detrimental to a session, i.e. creating a power imbalance between therapist and client to the therapist's advantage).
The person-centred way of working puts the client at the centre and removes the authority from the therapist. The neuro-affirmative way puts the autistic voice at the centre - that means your voice as the client but it also means looking for autistic-led research - research that's designed by and for autistic people, based on bettering their lived experiences, and not on making them better neurotypicals.
The neuro-affirmative model looks to the social model of disability (what about the environment is disabling for the person) rather than the medical model of disability (what's wrong with the person) and takes a stance against social skills training and behavioural corrective training like ABA (Applied Behaviour Analysis - the founder of this is also the founder of gay conversion therapy).
The neuro-affirmative way recognises the value of living a disabled life and advocates for social/systemic changes in the environment and culturally.
There is quite frankly so much more to say about this way of working and I hope we'll see more and more books and research articles focus on this as well as practitioners embracing this way of thinking. But it doesn't just involve neurodivergent people but all minority groups and all groups that are being discriminated against as well as the whole mental health paradigm (as seen in the 'Power Threat Meaning Framework' by Dr Lucy Johnson).
It's moving away from seeing people as problems ("what's wrong with you?") and seeing them as people impacted by their environment ("what happened to you?") and about looking at people's strengths, abilities and networks to support them rather than dive and disappear into a problem-saturated narrative.
Side-rant to illustrate my point: Data has shown that the use of anti-depressants go up in winter and there's a rise in bi-polar diagnoses in spring... To me that indicates that we're not meant to stay as productive and 'happy' in the dark months but perserve our energy and sleep more but that's been pathologized by our capitalist society so you get pills to 'be normal' and maintain the same level of energy and engagement as the rest of the year. Likewise, an increase in bi-polar diagnoses (going from depressed to hyper-happy) in spring indicates to me that we've pathologized the evolutionary advantage of having extra hyper energy for hunting and foraging after a long, hard winter. What if we've been diagnosing people as 'faulty' based on an incredibly clever, millions-of-years-old, inbuild, biological, seasonal clock that made perfect sense when we lived in caves but seem problematic in a society obsessed with productivity and money?
In the same way that everything in the diagnostic, deficit-based, manual about autism can be flipped to be seen as important or essential traits as part of a tribe.
Looking at the autistic sensory profile, might autistic people have been able to smell snow coming or feel a thunder storm before arriving, able to warn their tribe to buckle down and survive weather changes? Or smell dangerous foods from safe ones? Might their pattern recognition have been used to identify safe versus unsafe foods, like mushrooms?
Much like ADHDers would have made amazing hunters. Their way of being motivated by novelty and spontaneity would have been essential traits when someone spotted bisons on the other side of the valley. But when we live in a world full of cultivated farmland with a strict planting and havesting schedule using boring, repetitive and predictable means of planting and havesting, no wonder ADHDers suddenly look "lazy" in that context. But they're not lazy. They're being forced to use their brains in a neurotypical way and their strengths are being disregarded.
That's the problem with the power imbalance and systemic issues in a neurotypically designed world. And that's why words are so important because it can change everything in mere seconds. People who've thought they were lazy their whole lives suddenly learn that they're under-stimulated. Or people who've been called slow to respond can suddenly see that they're not slow, they're thorough in their processing - vital for coming up with new solutions to hard problems and why there are so many autistic people working in science and other professions that demands 'outside-of-the-box' thinking and creative problem solving.
I hope you find the idea of working with words as fascinating as me and that you see the value in an affirming approach.
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P.s. As a dyslexic person I won't catch all my mistakes. Please read generously and if you spot any mistakes, I hope you'll smile with kindness because I'm allowing myself to unmask my dyslexia in your company.