How therapy can help the neurodivergent client

Before beginning this article, it may be helpful to define some key terms that will be used throughout. The word neurodivergence refers to differences in neurocognitive functioning; these differences distinguish a neurodivergent (ND) person from a neurotypical person. Neurodiversity is a more general term describing the whole spectrum of variation in neurocognitive functioning as seen across humanity.

As someone with dyslexia, I identify as neurodivergent and hope to offer some insight gained from my own experience, but also that of the many ND clients I have worked with. 

Neurodivergence encompasses a wide range of diagnoses including autism, AD(H)D, Tourette's syndrome, dyslexia and dyspraxia, to name a few. However, many ND people are not diagnosed with a specific condition, either because it has not been identified, or because they have chosen not to seek one. This by no means undermines the validity of their neurodivergence. 

Coming from a neurodiversity-affirmative and person-centred standpoint, I avoid using medical terminology where possible.

Why might an ND person seek therapy? 

While an ND client may come to therapy for many different reasons, possibly for something completely unrelated to neurodivergence, often this aspect of their lives will underlie at least some of the presenting issues. 

The term neurodiversity was only coined in the late 1990s, so it is likely that many clients coming to therapy now may have grown up in a culture that neither recognised nor understood their neurodivergence. If more pronounced, perhaps they were diagnosed with a "condition", "specific learning difficulty" or "disorder". These terms all denote a deficiency or problem to be treated, rather than highlighting any strengths of the way the ND brain functions. 

Those with more subtle neuro-differences, or whose environment was too threatening to reveal their differences, may simply have learnt to cope by masking and adapting to meet the expectations of families, schools or employers. This involves a detrimental rejection of the authentic self which can lead to a sense of disconnection and emotional distress. 

Even if the ND client did receive some recognition and support when they were growing up, there has still been an expectation for individuals to conform to the structures of society, rather than adapting the environment to suit their needs and preferences. This is the problem with a one-size-fits-all culture, as is evident in our school system which still measures all students using the same yardstick, potentially setting those with differences up to fail. 

The impact of being misunderstood, criticised, unsupported and conditioned can be seen in ND clients presenting with low self-esteem, shame and distrust towards self and others. 

How can therapy help?

The therapist is interested in how a client experiences the world as a unique individual and tries to understand what it is like for them living with neurodivergence. They invite the client to open up honestly about their thoughts and feelings, without judging them. Attention is paid to the client's strengths as well as difficulties, creating a space where their uniqueness is celebrated and valued. It can be hugely validating for the client to finally be seen and accepted just as they are. 

Therapy allows a trusting relationship based on equality and respect to form. This is really important for the ND client, who may have difficulty trusting and relating to others. Within a safe environment, the client can begin to unmask and show their true self. 

Assuming the therapist has a good understanding of neurodivergence, the client's needs can be put at the centre of the work. For instance, the environment may need to be adapted, extra reminders given for sessions, and information and resources be given in different forms. This gives opportunity for the client to voice their individual needs, thus building confidence and autonomy.

Therapy also offers the space to explore what a formal diagnosis might mean for the client if they do not already have one. Not everyone wants to go through the often lengthy or expensive process of pursuing an assessment, and this may not be necessary. However, for some, the possibility of receiving financial, educational or workplace support can bring relief and hope. 

Final thoughts

Neurodivergents bring to the world creativity, ingenuity, deep insight and sensitivity. Re-shaping our culture so that ND people are accommodated, valued and given the conditions to thrive will benefit the whole of society. I believe that therapy, done well, can contribute to this bright vision for the future!