Challenges Autistic People and ADHDers Face in Therapy and What Can Help
I remember being fourteen, sat in a CBT (Cognitive Behavioural Therapy) session and being completely bewildered by what the lady was trying to teach me. I was having daily panic attacks - some of them more likely meltdowns - because I was so overwhelmed. I began describing how I didn’t want to go into the canteen because of the noise and having had a panic attack there. She replied “But don’t you think everyone feels like that, to some extent?” (or words to that effect). Then she guided me to the textbook to look at a cycle of thoughts, feelings and behaviour, none of which I felt able to apply to myself because I didn’t know how I was feeling aside from the racing of my heart and funny feeling in my chest, and how I could possibly stop this from affecting my behaviour?
The sessions felt hard and pointless, but I purposefully gave higher scores on my end of therapy questions because I didn’t want her to think badly of me and I didn’t want it to seem like I hadn’t tried.
The reality was that I was autistic and ADHD, but neither of us knew. This approach to therapy of course wasn’t going to help because the noise WAS too loud and I COULDN’T identify how I was feeling - other than the panic. My thoughts were very fixed, my black and white thinking not understood and nobody was considering that how I experienced or understood things might be different.
“Therapies applied without awareness of the autism can be harmful or, at the least, ineffective.”
I then asked autistic and ADHD people to share what would help them to engage in therapy. These were the most common responses.
Sadly, around 80% of autistic people and at least 50% of those with ADHD experience mental health problems throughout their life - though figures vary between research studies. I wrote about the high prevalence of mental health difficulties amongst autistic people here.
Unfortunately, there are neurodivergent people who are turned away from services because they are struggling but it is deemed to be related to their neurodivergence, so they are left without support. But this isn’t ok, especially when around 40% of suicides could be autistic people (20% being undiagnosed) and suicide is also higher amongst those with ADHD.
Autistic and ADHD people need mental health care too. In-fact, we are more likely to need it than our neurotypical peers, because we are much more likely to have experienced trauma, discrimination, depression and other mental health challenges. So we need access to support. We just also need our neurodivergence to be understood and recognised, and therapies and support to be adapted for how our brains work. That shouldn’t be too much to ask.
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