Episode Transcript
[00:00:00] Speaker A: If we aren't monitoring, and often with ADHD and autism, we don't have the interoception, our entitled guide on our own emotions, our energy level, all those things. So we don't actually realize when we're getting exhausted until we are done.
It feels like often for me, if I'm going out at a social event, everything's wonderful, everything's wonderful. And then I crash and I'm like, everything was fine. Why, why do I need to go home now?
[00:00:30] Speaker B: Hello, everyone. Welcome to the Safer Police Therapy podcast. My name is Daniel Di Pietro. I'll be hosting today instead of Stu Shelton, who is the regular host of the podcast.
Today we're going to be exploring ADHD and Audi HD with one of our wonderful practitioners here at psychlase Therapy, Stephen.
Before we begin, I just want to pay respects to the traditional custodians of the land, the wandering people of the Kulin nation, and pay respect to their elders past and emerging.
And I'd also like to name that land was never ceded and that land is and always will be first nations land.
So, Steph, welcome to the podcast.
Hello.
So in terms of us starting today, why don't you tell the viewers here a little bit about you?
[00:01:27] Speaker A: Okay. Well, I'm Steph or Stephanie. I really don't mind. I'm a provisional psych here at SafePlace and I focus on working with primarily adults with autism, ADHD and also disability.
[00:01:43] Speaker B: So tell me a little bit about, or tell the viewers, should I say a little bit about what interested you in. In that field? And it sounds like that you have a lot of passion about it as well.
[00:01:54] Speaker A: Yeah, I find it really interesting. I always wanted to be a psychologist, but I didn't really know where I wanted to work, what sort of specific space.
And it wasn't until I was studying psychology that I actually started really struggling. And it was around that time that I was then diagnosed with ADHD and then subsequently realized I also have autism. That I realized that this is actually a huge area that the population need a lot of support on and it's not really there. So it became a bit of a passion point for me.
[00:02:33] Speaker B: Yeah.
[00:02:33] Speaker A: You know, as you, as we do when we go into our own journey, and it sort of grew from there, that that was where I wanted to be, that's where I wanted to work.
[00:02:41] Speaker B: Yeah. I mean, so in terms of your clientele, so can you tell, I guess the viewers here in terms of who you enjoy, see and I guess some of the work you do in that space?
[00:02:53] Speaker A: Yeah. Sure. Like, really enjoy seeing newly identified or diagnosed ADHDers and autistic people and also people that are struggling with disability.
I really like helping people with that journey and understanding, you know, where they're at now, how it differs from before, but also what they're still capable of or in terms of the ADHD and autistic population, how to help support them, to understand their brain, their neurotype, and how to work effectively with that to reduce some of their distress.
[00:03:28] Speaker B: And that sounds so affirming.
Can you talk into, I guess, some folk may experience, I guess, neurodiversity, having kind of a deficit lens? Is that something that you feel like that you try and, yes, look at and affirm perhaps some of the challenges, but also look at the person's strengths?
[00:03:50] Speaker A: I will be honest here. It drives me a little bit mad when people refer to people with ADHD or autism as having superpowers, because to me, that really diminishes the cost of what these people go through. So I really don't go towards the superpowers kind of way of being. But there are definite strengths to ADHD and to autism, and we definitely want to be affirming those. But I feel like, especially with people that are newly diagnosed, a lot of the work tends to be around helping to rewrite their experience because they've lived, usually many, many years with the understanding that they are somehow a failure.
And now that we've got this new understanding of what's been going on for them, we can tell them and help support them into reframing that and seeing themselves as. No, I am just a person that has been struggling with this disorder that makes these things harder for me. This isn't me being unable to do this thing or too lazy to get something done.
So I feel like a lot of the work is in more that space and helping with that reframe, which in itself is so freeing, I think, for a lot of us.
[00:05:11] Speaker B: Yeah. And can you talk about some of that work in terms of, I guess, what that looks like for you in the therapy space?
[00:05:19] Speaker A: So in the therapy space, you know, like, I'm neurodivergent myself, so I'm very comfortable talking, you know, with my clients and explaining, like, you're not alone in this. This is a very common experience. And a lot of the times, it's also something that I can relate to. I feel like having just somebody else be able to say, like, oh, yeah, getting our homework done on time, that's a trial.
So I feel having that kind of neurodivergent therapist in the space can be very helpful. But what I try to do is make sure that everyone is comfortable in this space. I've got a big whiteboard, so we can do some visual stuff if we need to put something down. We've got space for verbal processing. We can adapt for sensory needs.
And just really trying to make the space and therapy in general as comfortable as possible for the individual.
[00:06:15] Speaker B: Yeah. I mean, I really love how you're talking about your work, and it's. It's really beautiful to hear that it's very subjective on the person and their experiences.
[00:06:27] Speaker A: Yeah.
[00:06:28] Speaker B: Can you talk a little bit about why that's so important, particularly when working with neurodiversity?
[00:06:34] Speaker A: Oh, definitely. Like, it's not one size fits all with us, like neurodiversity, the idea that we are neurodivergent, it's not that we are all this weird, different other type from neurotypical. The idea is we're neurodiverse, which means they have multiple differences and individual differences across these sort of broader categories that we're trying to frame with our little dsm.
So what ends up being really important is actually seeing the individual as the individual, so meeting them where they are and being able to be flexible about their needs and how to support them or how to just help make the space that little bit easier or how to work with their specific goals.
And I think that's what makes a big difference for clients coming into therapy that maybe have been to therapy before and it hasn't been as effective.
But now having that, I think, foundation and sort of coming to therapy with it, being about that whole person as an individual, I think makes it a very more tailored kind of therapy, perhaps more effective.
[00:07:48] Speaker B: Yeah. And, you know, I. I also.
I know that you're an art therapist as well, and I really want to talk about that in terms of working in the neurodiverse space there. Can. Can you tell me a little bit or tell the viewers a little bit about your.
The way that you do art therapy when you're a diverse one? Yeah.
[00:08:05] Speaker A: Like, so, again, really depends on the clients. Some clients come in and they're like, no, not for me. And that's. That's perfectly fine. We don't force it on anybody.
[00:08:12] Speaker B: No.
[00:08:13] Speaker A: But it can also be very helpful as an alternative means to express oneself. And I think for a lot of us, there tends to be some creative streak somewhere. There's something that we do that we have an outlet or we have a desperate need of an outlet. So I Think that can often be something that's really good to encourage.
But in the room, we've got a large table we can set up. We've got capacity to use everything from acrylic paints to graphite, charcoal colored pencils, textures, oil pastels, whatever. And I've got a huge range of stuff at home. So if there's anything that anyone's interested in, I can probably bring it in because I hoard.
So with that, some of it is okay, we need to prep. I need to be aware of this, the session before to be able to set up. But a lot of it is we could be in the middle of a session and it could be like, oh, actually what's coming to mind for me is an art therapy activity. And that I think suits where we're at right now. So for example, we're looking at identity and how someone sits, maybe how they feel perceived versus who they are. We could look at an art therapy activity that's based on identity and we could just bring that in if the client's feeling out for it. So it can be really versatile, but I think often it can suit our weird neurodivergent brains a little bit better. To have an alternative means. That's not just the talking.
[00:09:37] Speaker B: Yeah. Another way what I'm hearing is expressing.
[00:09:40] Speaker A: Yeah. Expression is huge.
[00:09:42] Speaker B: Yes.
[00:09:43] Speaker A: I really think that worldwide we've kind of lost, I think just the genuine joy that comes from an individual having a means to express themselves. Like it's not just communication, it's emotional regulation.
It's just that productivity, that feeling of accomplishment. It's like the idea that when we have a hobby, having a hobby with the goal of just maybe even being a bit mediocre at that hobby, that is incredible in itself. We're doing it for the fun of it. Because if we keep putting everything to this sort of skill, mindset of I have to achieve, I have to reach the next level, then that's stress, that's pressure.
When do we relax for our brains? A really great way to not only relax but also rejuvenate us. Because burnout is a. A huge issue we have is to do something that is self expression.
So for myself, I've had to really work on balancing when I'm working here with clients and then when I go home, how do I do self care? And it's doing a lot of artwork.
So I've got stuff set up at home. I've had to fiddle around and make a permanent space for it. Because if we don't have something accessible that's just barriers to doing the thing and it never gets done.
And I've had to work on really having that distinct set of time that is, this is where I express myself. This is where I do those things that make it a lot easier for me to cope in the world, but also to continue doing my work and hopefully supporting everybody else.
[00:11:22] Speaker B: And what's really beautiful about hearing about that experience is that you're talking about tailoring therapy for the client, but you also practice what you, what you preach as well for yourself and tailor it for you to be accessible.
[00:11:36] Speaker A: Yeah, like there's so many things and I feel like I tend to work in quite a problem solving kind of way. So we do really benefit a lot of the time just from verbal processing.
So doesn't completely disregard what I said before. We're very good at needing, you know, visualization ways to express ourselves. But a lot of the time we, we talk to ourselves, we talk ourselves through the steps of something or, or we sort of journal. We need to just get the thoughts out to make sense of them. And you can do that sort of visually or more verbally. And a lot of the time for, I'd probably say maybe, maybe a third to even a half of my clients really just value having a space where they can just blah. And then we can start making sense of what comes out and problem solve. Like, okay, we've got this issue with maybe your workplace.
How do we help? How do we make that more, you know, like sensory? Like, how do we deal with some of those sensory issues to make that workplace suit you better?
[00:12:39] Speaker B: Yeah.
[00:12:40] Speaker A: How do we problem solve this?
So I feel like there's a huge area of my work that is very problem solving.
[00:12:47] Speaker B: But also, once again, it sounds like it's quite tailored for your clients, which it's so lovely to hear.
[00:12:53] Speaker A: Yeah.
[00:12:54] Speaker B: And, you know, it's really wonderful hearing about what you do and just a little bit about you. And, you know, I want to come back to, I guess autism and Audi HD as well. And can you share with the audience, you know, the, perhaps the differences between both?
[00:13:15] Speaker A: So firstly to go into Audi HD is we have to cover that this wasn't something that you could be diagnosed with. You couldn't have both before the last update to the DSM because it was considered that they were quite conflicting, so you'd only be diagnosed with the one that seemed to fit you better or seem more severe.
What's happened since then is we've started to understand the interconnectedness of ADHD and autism. So Even though they themselves are very conflicting disorders that you've got order in autism, you've got chaos in adhd. They don't really mesh well together, but they are very connected. There's a huge overlap between them. So with that sort of discovery and the more recent research, we've realized just how connected they are. And the likelihood that someone has one and then also actually has this other is something like up to 50%. It really depends on where you're looking and what the most recent research is.
So it's very prominent that you will have traits of both. One might be more distinct. And usually when you diagnose one and start understanding one, or especially when you start medicating for adhd, the autism or the other one will become really obvious because it's all the leftover things that aren't getting explained.
So what you end up with is the very ordered, regulated, routine kind of thing of autism, where we absolutely thrive in having, you know, repetition, predictability, stability.
That's just our jam. And if you know an autistic person that has meltdowns, you probably witnessed a meltdown. It's usually around something, interrupting that something.
Yeah, something that gets in the way. There's some change to expectation. There's something that really throws off like what we expected was going to happen. But than in adhd, it's just chaos. It's, I want to do a thing, I can't do the thing. It's, I know what I should be doing, but I can't get the motivation to do it. And we, especially when we don't have a diagnosis, we don't know why we end up blaming ourselves. So you also end up, especially in late diagnosis, with a huge amount of shame because why can't I?
Why like I, I am capable, like in a certain magical set of circumstances, I can do this and I can get like, you know, A's, I can get flying colors.
But outside of that magical set of circumstances that I also can't seem to identify, I can't just do it and it doesn't make sense.
So there's a lot of conflict in that, I think a lot of sort of internalization, especially on, on the AFAB side of things, where it becomes shame.
[00:16:06] Speaker B: And for the viewers who don't perhaps know what afab.
[00:16:09] Speaker A: Yes. So assigned female at birth for that one. Apologies for the acronym, but we're discovering now as well, so with the increase in research that there is a higher proportion of people that are AFAB that experience ADHD and autism than we thought previously.
So honestly, it probably feels like ADHD and autism and diagnoses and labels are coming out of the work. They kind of are. But it is because of a lack of research.
[00:16:37] Speaker B: Right. And it sounds like that research is now finally catching up.
[00:16:41] Speaker A: Yeah, because, like, the expectation was that ADHD was, you know, that stereotypical, you know, young boy that can't sit still. But we've missed the girls. We've missed everybody with an internalized presentation. We've missed the overlap of autism and adhd. We've missed these in adulthood because we also thought you'd grow out of adhd.
There's so many different factors that really came together to kind of neglect a whole lot of populations that now is where trying to catch up. And especially I think through Covid, with the increase in people being at home, like, realizing, oh, maybe I can function in this work capacity, but you leave me at home with nothing else to do. Everything just.
I just keep coming back to chaos. Like, I can't keep organized. I can't keep on top of things. My kids are driving me insane.
Like, we can't put structure. There's no routine.
So it's when the structure around us sort of begins to crumble, or when we move from something like a really structured primary school and even high school environment into university or, you know, other work that is a lot less structured. Your teachers aren't coming at you, telling you, hey, remember, you've got your assignment due soon. It's all onto you. We've lost that structure.
And we realized we don't actually have the skills to stand on our own and get this done because we've been in an institution that's focused more on the neurotypical brain.
[00:18:09] Speaker B: Yeah. So it sounds like you're talking there about a kind of society that's set up for one kind of neurotype.
[00:18:17] Speaker A: Yes. And I think it was kind of a bit arrogant of us historically to have assumed that there is only one type of brain and anything that deviates is wrong.
Because, like, I really love an example by Ciaran Rose, who is online the autistic advocate. Really love him. Great training.
He sort of says if you think of trees, you think of how many different trees there are out there, how many different species of trees, how many different location trees are in. You've got trees with fruit, trees with nuts. I don't know that much about trees. Trees that just look really cool. You've got, like, winter trees that lose all the leaves, ones that go lovely colors. Like all of these different types of trees.
Why Would there only be one type of brain if in nature we have so much diversity, it doesn't really make sense when we look at it in hindsight. So I like to think of this whole neurodiversity thing that seems to have also just come out of nowhere in the recent years.
As we're looking at everything now, trying to incorporate this diverse framework of everyone's different. There are going to be differences at the individual level. They're going to be differences in the family level in genetics.
[00:19:35] Speaker B: Are you talking there with autism and all DHD or neurodiversity?
[00:19:40] Speaker A: Neurodiversity as a whole? Yeah, yeah, because it's not to neurodiversity, like neurodivergent, rather technically covers any brain difference.
So some people. There's a bit of an argument where some people, like, does that include brain differences as you develop them over time as you age?
So that would be something like ms, where you have brain lesions and that's something that you weren't born with.
[00:20:05] Speaker B: So that's more of an acquired.
[00:20:08] Speaker A: Yeah, in a sense. Like it's sort of a tricky space so that it can get.
[00:20:13] Speaker B: There might be another episode.
[00:20:15] Speaker A: Yeah, there are some conflicting opinions there, but in general, I see it as anything that makes your brain different from the expectation.
And frankly, it's not something that we have previously catered for in the school system.
There have always been kids that learn differently, kids that are better doing than sitting in a classroom.
And it's little things like that where we really need to have more input in the school system of how to make this work for everybody. Because academics, achievement, learning should be accessible for everybody. And it shouldn't be something where our adhd, our difficulty motivating ourselves, or the burnout we experience when our sensory issues aren't catered for.
That shouldn't exclude us.
[00:21:11] Speaker B: No. And I'm hearing the real inclusivity of everyone, no matter what brain type they are. Yeah.
[00:21:18] Speaker A: Oh, definitely. Like, it's interesting, but the accommodations that are often put into schools for autistic or ADHD children, they benefit the whole classroom. And not just because like that stereotyped ADHD boy is maybe now sitting a bit more still.
Because it's like all kids love a little wobble seed. There's just regulation strategies, there's timeout strategies, and in the end, the benefit from having these for everybody in that classroom are going to be better regulated kids, kids that grew up with an improved understanding and the skill of how they work and what sort of helps them to do things and Also without the shame of I can't do this or the thing that helps me get this done isn't allowed in the school ground.
[00:22:09] Speaker B: Any parent watching of a child or a teen who's living with neurodiversity and wondering if it will be okay if you could share some maybe, tips or perhaps how a parent could be of support to their neurodiverse child and team.
[00:22:26] Speaker A: So the biggest thing is understanding a bit of whatever they're diagnosed with. So adhd, autism, or if it is just a difference, even something like Tourette's, like a huge range of difference under the neurodiversity umbrella.
Have an understanding of the condition, but also try to understand your child's experience of that. And keep in mind as well that some of these conditions are very genetic. So this may be something that you or other members of the family are struggling with as well.
And it can help to really normalize some of these things. But I think often the best support we can be is just being an advocate. You know, whether it is just being able to tell your child, like, hey, I know that that was hard. You know, this thing that you're doing, whether it's going to school, whether it's, you know, coping with a sibling that keeps taking your favorite toy, whatever it is, these are hard things to cope with. And supporting them and validating them in that, I think can be really important because we don't want to diminish the experiences of ADHD and autism. The differences. Like, I grew up always being told I'm too sensitive.
And what that led to is an adult that doesn't often trust themselves when they have what's honestly quite a legitimate emotional response to something. Yeah, because I just keep thinking, oh, I'm overreacting.
Which can put, like, I've done a lot of work on that, but it can put you in a really bad position of assuming that you know how you're feeling isn't valid and therefore you shouldn't act on something. So if someone's crossing your boundaries, if someone is pushing you too far, you don't perhaps stand up and, you know, stop that when you should.
So I'm very big on where we can. We want to emphasize that this is a valid experience. This is exactly how you're feeling. How do we help that?
Whether it is. How do we perhaps reduce the instances of this happening, or how do we help us cope with the big feelings that we have?
Because I think that's where a lot of this starts. We just need to be able to and I think from your EFT lens, the idea of helping people sit with their emotions can be really, really important.
[00:24:48] Speaker B: And there's a beautiful crossover in terms of, I guess, for folk who are listening and maybe have been questioning if they are living with autism or are living with Audio hd. I'm wondering if maybe you can share what perhaps are some signs that can be of no use to them or can help them seek further support.
Yeah.
[00:25:13] Speaker A: So the biggest thing is if you are struggling, there are therapists always willing to help out.
But most notably, I think in adhd, it's often when our demands have sort of exceeded our ability to cope, and that's when things feel like they're falling apart. It could often be, okay, we're managing maybe the household, we're managing a work life, we're managing a social life, but for one of these to function well, the other two are just in utter disrepair.
[00:25:44] Speaker B: Right. We'll have to kind of go by the wayside.
[00:25:46] Speaker A: Yeah, yeah. Because, you know, we can't juggle so much effectively. One of the key things with autism is often actually burnout.
[00:25:55] Speaker B: Right. Okay.
[00:25:56] Speaker A: So that, especially in kids, will look like school can't or school refusal, which we prefer. This point where we might be querying, like, is this like an illness? Is this chronic fatigue? And there is also an association. So we don't want to rule that out.
But it can be this pattern of I am fatigued for X period of time and then, you know, maybe I need to take time off work, I need to reduce the demand and then I feel a bit better, I push myself and then I'm back here.
And you also get that in adhd, that boom, bust cycle where we get all of our enthusiasm and motivation, we jump on all these things that impulsivity and novelty seeking and then, you know, we're back down again.
[00:26:37] Speaker B: Right.
[00:26:38] Speaker A: Because we've used up our energy because we don't have the balance of self care to support that and rejuvenate that. So that's the especially self expression that we chatted about a bit earlier.
So it sort of ends up being this really kind of flat presentation where it's not quite depression, it's not a, like a loss of enjoyment in things, but rather it is I do not have the energy to do the things that I love.
[00:27:07] Speaker B: Yeah. So it sounds like a depleted battery.
[00:27:10] Speaker A: Oh, exactly.
[00:27:11] Speaker B: Yeah.
[00:27:11] Speaker A: And like, we really like spoon theory in autism. The idea of, you know, if we put our energy into spoons that we have for the day, so there's often spoon theory or the idea of social batteries and work batteries. And I think that works really well to visualize what this is like.
[00:27:27] Speaker B: And can you talk, I guess, about spoon theory just a little bit? I know it's quite fast, but how do you feel that spoon theory helps folk living with autism or Audi hd?
[00:27:39] Speaker A: So the idea. So all of these are energy pacing kind of ways to visualize what we have each day and how to essentially accommodate for what we want to get done each day and how to actively plan.
Because if we aren't monitoring, and often with ADHD and autism, we don't have the interoception, our internal sort of guide on our own emotions, our energy levels, all of those things. So we don't actually realize when we're getting exhausted until we are done.
It feels like often for me, if I'm going out at a social event, everything's wonderful, everything's wonderful. And then I crash and I'm like, everything was fine. Why, why do I need to go home now?
So it can sort of be like that, where it gets to that point where we've lost all the signs before, that we don't know what they are. We're not attuned to that. And then it's like, nope, now we need to leave.
[00:28:34] Speaker B: Right. So it sounds like a real monitoring of energy, energy levels there.
[00:28:39] Speaker A: And spoon theory, the battery kind of thing, they're just different ways to kind of visualize it, to calculate it. I do find a bit of a criticism that comes up sometimes for spoon theories, but how many spoons? Like, how do I calculate what is a spoon? But the idea is to sort of work out a number of spoons that you prefer as your. This is what I wake up with.
[00:29:00] Speaker B: So it doesn't have to be specific, no number. It's just subjective.
[00:29:04] Speaker A: Yeah, yeah. I think that's where it kind of. I feel like that's where it bugs a lot of autistic people because, like we're.
[00:29:10] Speaker B: No.
[00:29:11] Speaker A: What? What? Which one? Give me a number.
Yeah, we like knowing.
So with that it's. We've got this amount that we back up with. And this is where I also give you the opportunity of like, maybe it's 100%, so maybe it's a battery.
But then if we are already burnt out, maybe when we wake up we only have like 50%.
[00:29:32] Speaker B: Yes.
[00:29:32] Speaker A: And if anybody has played Stardew Belly or a similar game, amazing system where if you don't go to bed, you will actually pass out at like 2am and then you wake up with like a very Depleted battery the next day really makes a lot of sense to people. Because you haven't had enough sleep.
[00:29:49] Speaker B: Yes.
[00:29:50] Speaker A: And what happens is when we get burnt out, it's this constant cycle of I haven't recovered enough to, you know, get back from what I've depleted before I go and I do more things. So we're constantly in.
That's the word for when you're hitting your reserves. You're constantly, like using up your energy reserves and they take so much longer to actually fill back up that we need that period of rest.
But if we don't have, you know, at the end of that period of rest, a system in place to help monitor how we are spending, we're constantly going to be in deficit.
[00:30:28] Speaker B: Yeah, well, I mean, that makes a lot of sense that it's just this complete rundown.
[00:30:34] Speaker A: Yeah.
[00:30:34] Speaker B: It is being in a consistent deficit, which, you know, is that what you feel like a lot of people report when you do see them living with neurodiversity?
[00:30:42] Speaker A: Yeah. Like, it is, I think, very typical, especially with the internalized presentations. So more afab, more minority groups and in that. I think a lot of that is related to late diagnosis because it's. These are things that haven't been structured to suit your needs. Because this is. You've been in an environment for too long where the demand on you is too high for you to consistently manage.
You know, and with accommodations, we can actually make this environment easier for you to cope with in a way that doesn't cost too much.
So we can make something that, you know, maybe we can't. We will do like a couple months at school and then we can't handle it anymore.
And this, if we make some accommodations, instead of it being like we've done this and then we've gone back down because we can't handle it with accommodations, it can just be this sort of solid flat line.
[00:31:36] Speaker B: Right.
[00:31:37] Speaker A: That's sort of the goal.
So it's really important that with somebody that is, you know, coming in and experiencing a lot of, you know, autistic burnout or ADHD boom and bust cycle, that we are able to start recognizing where we're at and then looking at the activities we've got and starting to sort of eye the cost.
You know, like, I really love going out and having, you know, beer with me mates, but there's something about the venue. Maybe it's too loud, too noisy. Maybe I'm out for too long. There's those little cons that do add up that if we can just make some Subtle shifts, or if we can do that a little bit less frequently, then maybe our overall well being will be a bit more improved.
[00:32:23] Speaker B: Yeah. And improve that. So coming back to AFAB foam, can you talk a little bit into, I guess, the late diagnoses around potential autism or dhc, why that seems to be the case?
[00:32:36] Speaker A: Yeah. So the biggest thing is that this wasn't a population that we were researching.
You know, we weren't identifying particularly AFAB and minority groups as experiencing autism. ADHD to degree. Yeah. So in terms of why there's so many more late diagnoses in afab, we really weren't looking, I think, in this population group for these symptoms. Like, the expectation was that ADHD was primarily a male disorder.
And then I think when going back
[00:33:10] Speaker B: to that kind of schoolboys.
[00:33:12] Speaker A: Yeah, definitely. Yeah. I also feel there was a cultural component as well. Like, I remember being a kid and having like news come up, like seven in the morning kind of thing with it talking about ADHD in America and how they're. They're medicating their children.
And it was just something that, like, I remember, ironically, as a family, I was sort of laughing at, like, these Americans, they taught, you know, they can't control their children. What is this?
And then, however many years later, I'm bad at maths. We all have adhd. It's like, oh, it's us.
So I feel it was also a bit of a cultural thing happening there, but with that expectation, we weren't looking in women. We weren't able to identify that internalized presentation that women or AFAB often have. And it's not exclusive to AFAB either.
But it's when instead of our behavior becoming something that we externalize, that maybe we get angry, maybe we throw things, maybe we can't cope in school, but it's really disruptive, which is, you know, the stereotypical example. Instead of that, we blame ourselves.
Instead of that, we maybe we shut down, maybe we have meltdowns. Maybe it just turns into more of a depression or anxiety response, so it becomes something that's harder to identify.
[00:34:39] Speaker B: Right. So if I'm hearing this right, is it almost like that from a gendered perspective, that for males it would often be external in terms of disruptive behavior, and more for females it would be around just internalized more, More typically.
[00:34:56] Speaker A: Yeah. So it was sort of the idea of, you know, boys are running up the walls and the girls are just staring out the window. You know, they're the daydreamers. But it. And that's also the divide You've got ADHD inattentive and ADHD hyperactive. I personally, I don't feel that there's much worth, I guess, in dividing it that way because I feel like if you are still inattentive, you've got hyperactivity of the mind.
There are other ways that you're hyperactive.
It's just less visible. So I tend to move away from that framework and go with externalized and internalized presentations. And with that, because we weren't looking.
Because as well, our criteria, especially for autism, is based in what like to meet criteria for autism in the dsm, you have to be a very distressed autistic person. So you can be autistic. And again, at dsm, the way that we categorize things is sort of current science. Best guess of vague lines around when something becomes problematic and not in such a negative way problematic for the individual. Dysfunctional when we start experiencing distress kind of thing. Where autistic, even when we're good, you don't have to be distressed.
[00:36:13] Speaker B: On and off switch.
[00:36:15] Speaker A: Yeah. Like if you have perhaps a family system, a structure, a job that works really well for you, you've got things that maybe a good career in something that really suits your autism. So think engineers. Think like Silicon Valley, because there's actually a high percentage of autistic folk in Silicon Valley.
If it just works for you, then where is the dysfunction that equates to a diagnosis?
So if we look at it more that way, I think it makes a lot of sense that we've missed quite a lot of people because our diagnostic criteria is quite a distressed autistic person.
[00:36:56] Speaker B: Right. And which what I'm hearing then makes some people fly under the radar.
[00:37:01] Speaker A: Yeah, very much. And the thing is, if we took like I think virtually any autistic person from a very well structured, you know,
[00:37:10] Speaker B: so that they have thoughts in place.
[00:37:12] Speaker A: Yeah. Like if we took them either way, if we took them from a good place and put them into something that was very chaotic and they have very little predictability, you would start to see this dysregulation.
But if you took someone from, you know, a very chaotic environment and you gave them structure, you gave them predictability and stability and there would be drastic improvements.
So autism is a very variable, like variable kind of disorder.
[00:37:39] Speaker B: Yes.
[00:37:40] Speaker A: Like we've got the levels of severity, but they're not, they don't equate to consistency. Like it's not a. You are forever this level. It's often more related to this is the environment and the stresses that are around You. And this is how you're currently responding to those.
[00:37:57] Speaker B: So I'm hearing it's quite fluid.
[00:37:59] Speaker A: Very fluid. Yeah. And I think that's what's often missed when it comes to understanding autism. Yeah, yeah.
[00:38:05] Speaker B: Well, in terms of understanding them, you know, if folk want to perhaps seek support for autism or D H D, where are kind of the steps that people can take in terms of potential diagnoses or supports more generally?
[00:38:23] Speaker A: Sure. So for adhd it will depend on if you're looking for medication, because basically if you're looking for medication, I would recommend getting a psychiatrist for an evaluation, for an assessment.
But if you're happy to just kind of know, you can just see a psychologist or if you're younger, a pediatrician.
When it comes to autism, there unfortunately is no medication.
So that is often also as well. There aren't in my understanding as many psychiatrists that will diagnose autism and unfortunately those that diagnose ADHD don't also have that cross training.
So usually where a psychologist. This is the benefit of a psychologist diagnosing you with ADHD versus psychiatrist. There will often be a differential diagnosis where you are looking at ADHD and autism.
You want to be ruling out both or checking for both just because of that huge overlap.
But for a psychiatrist, you often don't have both checked out, but you do get a better access to medication. So it is, you know, which works a little bit better. And then for straight up autism, that is more, I think, in the realm of a psychologist. And again, we would be checking for differentials, but in that as well, if you're just looking for support, I find that a lot of my clients value having a neurodivergent therapist, but we don't always have the comfortability or like option to self disclose.
So I think if we look particularly for keywords such as neuroaffirming, that's often a good place to start when it comes to finding a therapist. But there are therapists out there, like myself, like a lot of my colleagues that have lived experience or a lot of experience working with this population.
So there are other ways to sort of find it. And really if you see a therapist and you're not feeling it, it just doesn't work. See a different therapist. There are so many of us, you've got options.
[00:40:23] Speaker B: So what you're saying there is. You don't have to stick with one if you're not feeling like you're getting this.
[00:40:29] Speaker A: Yeah, it's like anything. There are going to be people out there that we get along with really well. There's going to be people out there that for some reason we just. Hey, just. There's something about them. They just rub us the wrong way. And it's the same, you know, we're all different. We all work in slightly different ways. And really what you want is a space where you feel comfortable and where you're able to be vulnerable. Because that's where I think we get the most growth, when we are able to sort of experience some of that discomfort.
[00:40:58] Speaker B: Yeah.
[00:40:59] Speaker A: Yeah.
[00:41:00] Speaker B: Well, you know, Steph, this has been. I mean, we could film for.
[00:41:04] Speaker A: Yeah, this is fine.
[00:41:07] Speaker B: I mean, this has just been such a wealth of knowledge. And thank you so much for sharing your insights. And, you know, if any of the listeners are like me, I've learned a lot today listening to you here. And if you'd like to listen to any of our other episodes, feel free to click any of the links.
Otherwise, we'll see you again for the next episode there. And Safe Place is your safe place to talk.
[00:41:35] Speaker A: Bye, Sa.
