Acceptance of neurodiverse diagnosis – relief and grief

Coming up repeatedly, in so many of my client sessions, where clients have a diagnosis or suspected diagnosis of ADHD and autism, is fighting against the reality rather than working with it.

Pre-diagnosis

Imagine wishing and wanting to be different to how you are every day, yet the change doesn’t happen. There is frustration and anger that build up, sadness and low self-esteem can manifest within, and defence mechanisms become dangerously ingrained to try and cover the perceived ‘faults’. So much of my work is no different to working with neurotypicals too, accepting who they are and working to provide empathy and compassion towards themselves. Interestingly, much of the time this is exactly what they provide others without thinking!

Feelings around diagnosis 

Many a time there may be relief in diagnosis, but much of the time there is also huge grief associated with facing the loss of who you thought you were or could be. This is where acceptance plays a huge key role, the loss of trying to find permanent change/solutions to change their brain into a more neurotypical one, becomes acceptance of the disorder and working with it rather than fighting against it.   

Take for example a client with ADHD (diagnosed or suspected) who loses things constantly or is always late. The client berates themselves, as perhaps they were berated for these behaviours as a child, so the internal dialogue of ‘failing’ somehow is well ingrained. The client explores desperately why they can’t be ‘normal’ like their counterparts at home/office/school etc. However, with compassion and acceptance, we can reframe that being late and losing things will always likely happen because of their diagnosis, so the key factor is to focus on how we work with it the best we can for that particular client.  

Acceptance 

This is not to therefore change the neurodiverse into neurotypical wiring, nor always sit back and accept that is the way things are without any work (because the impact on their own lives and those around can be destructive) - but ‘acceptance’ means looking at practical ways to support these symptoms. It also means working on less defence and more empathy towards self when the symptoms do still arise, despite the efforts taken to work with them. The overall impact is a calmer internal dialogue which aids massively the emotional dysregulation symptoms which can co-exist with ASD/ADHD.  

Therefore, it is always my preference for a combination of types of therapy for the preliminary stages of diagnosis or exploring diagnosis. A combination of traditional person-centred therapy is useful, and for my therapy room, I also use some practical CBT and solution-focused options for the client to come up with and also try some suggestions to make sure they are also taking accountability for their symptoms.

Final thoughts...

The changes in a client’s self-esteem and negative thoughts positively correlate with acceptance of their diagnosis once they reduce berating or dismissing the impacts of their symptoms. The empowerment of acceptance leads to solutions to help manage symptoms that work for them and with this empowerment comes a more positive way forward.