If you’re seeking neuroinformed and neuroaffirming care, Neuroaffirming Therapy (NAT) is a modality specifically tailored to supporting autistic and ADHD clients. In this blog post, you’ll learn how NAT embraces neurodiversity and rejects pathologizing neurodivergent traits.
Neuroaffirming Therapy Explained
Neuroaffirming Therapy (NAT) is a therapeutic approach specifically designed to support autistic and ADHD clients by embracing the neurodiversity model and rejecting the pathologization of neurodivergent (ND) traits. Unlike traditional therapeutic strategies rooted in neuronormative logic, NAT is anti-oppressive and challenges the belief in a singular “normal” or “correct” mode of neurological functioning.
NAT employs neuroinformed, inclusive, and supportive practices designed to meet the unique needs of ND clients. It amplifies the client’s voice, exploring, validating, respecting, and celebrating their diverse experiences and identities. By emphasizing cultural humility and recognizing the importance of intersectionality, NAT actively opposes structural ableism and aligns with the core principles of the critical psychology movement.
Every Neurodivergent Person Is Unique
Stephen Shore, an autistic scholar, famously stated, “If you’ve met one person with autism, you’ve met one person with autism.” This phrase reflects the diversity within the ND community. For instance, one autistic individual might be reclusive, avoiding human interaction, while another might be a high-masking social butterfly. Similarly, one ADHDer might struggle with daily routines, whereas another might be a hyper-productive workaholic. NAT therapists recognize the individual nature of each ND’s experience, shaped by intersectional identities such as gender, race, and sexuality.
Neurodivergence Is Dynamic
NAT views neurodivergence as a natural variation in neurocognitive functioning, not a disorder. Autism and ADHD are considered neurodevelopmental conditions in the medical field, but NAT regards them as neurocognitive profiles that deviate from socially defined neurotypical (NT) norms. Neurodivergence is dynamic and shaped by genetic, environmental, and evolutionary influences. For example, gastrointestinal symptoms linked to gut microbiota can affect neurodivergence, and ADHD traits can fluctuate over a person’s life. Trauma can also intensify ADHD traits, highlighting the interaction between neurodivergence and environmental factors.
Pathology Often Co-Occurs
While NAT does not pathologize neurodivergence itself, it acknowledges that it can coexist with other conditions. Neurotypes like autism and ADHD often accompany additional challenges, which complicate and confound the diagnostic process. Adverse childhood experiences (ACEs) serve as risk factors for various mental disorders, significantly increasing the likelihood of ND clients developing psychopathologies later in life. NAT practitioners assess for concurrent pathologies and address them to support ND clients.
Ableism Is Pervasive and Pernicious
NAT practitioners understand that structural ableism creates systemic barriers hindering access to resources, opportunities, and fair treatment for NDs. These barriers can range from historical eugenic policies to modern practices like electric shock therapy used on autistics. Neuronegative attitudes towards autism and attempts to “cure” it reflect ongoing ableism. Structural ableism also manifests in environments, where NDs may need sensory-friendly spaces for mental well-being. Social interactions further perpetuate ableism through behaviors like silencing, shunning, stigmatizing, shaming, and subjugating NDs.
Ableist Standards Are Internalized
Neuronormative standards perpetuate the belief in a singular “normal” way of functioning. NDs frequently face expectations to conform to these standards, such as managing schedules independently and adhering to social protocols. This one-size-fits-all approach fosters feelings of inferiority among autistics and ADHDers when they struggle to conform. NDs often receive minimal help and are pressured to “try harder,” implying that their difficulties are simply a matter of willpower. This stigmatizing experience leads to NDs internalizing ableism as shame.
Ableism Creates Minority Stress
The minority stress model, initially developed for sexual and ethnic minorities, applies to ND populations as well. NDs face stigmatization and rejection for non-neuronormative functioning, leading to ongoing stress. They may internalize negative societal attitudes, affecting their self-esteem and mental health. To fit in, NDs often engage in masking, camouflaging, and compensation (MCC) strategies to conceal their neurodivergence. Minority stress significantly affects the physical and mental health of NDs, especially those with intersecting identities.
C-PTSD Is Common
Chronic and episodic environmental stressors, experienced cumulatively as traumatic, can lead to complex post-traumatic stress disorder (C-PTSD) in NDs. Bullying, a common experience among NDs, can be highly traumatic, especially without access to protective social responses. This phenomenon, referred to as “ambient trauma,” often results in C-PTSD. Insecure attachment, prevalent among ND populations, further increases the likelihood of developing C-PTSD.
Rigidity Is a Natural Response
Cognitive rigidity, characteristic of ND neurocognitive profiles, can also be a response to oppression. Rigidity emerges as a coping mechanism to minority stress and increased allostatic load. Chronic exposure to neurostress—unique neurological stress experienced by NDs—leads to neurostress responses like overload, shutdown, meltdown, and burnout. Cognitive rigidity helps maintain stability and protect mental well-being but can become maladaptive.
Challenges Are Biopsychosocial
ND challenges are developmental and influenced by biopsychosocial factors. NDs may struggle with interpreting social signals and understanding their implications, affecting communication. Attachment insecurity and trauma exacerbate these challenges, creating a negative social feedback loop that isolates NDs. NAT practitioners address all biopsychosocial considerations, providing social skills coaching, interventions targeting attachment and healing, and education about the social feedback loop.
Concluding Thoughts
Neuroaffirming Therapy offers a compassionate, inclusive approach that celebrates neurodiversity and supports the unique needs of autistic and ADHD clients. By rejecting pathologization and embracing neuroinformed practices, NAT fosters a therapeutic environment where NDs can thrive. Understanding the pervasive impact of ableism and addressing the biopsychosocial nature of ND challenges are crucial in promoting mental well-being and resilience among NDs. As society moves towards greater acceptance and inclusivity, NAT stands as a beacon of hope for a more equitable and understanding world.
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