I interviewed Dr. Joel Schwartz (JS), a neurodivergent psychologist who runs a group online for neurodiversity-affirming professionals who support autistics and other neurodivergent (ADHD, Tourette’s, dyslexia, etc.) people.
I wanted to know what it meant to be neurodiversity-affirming and how professionals can get it right when it comes to serving teen and adult autistic clients.
Here is that interview.
Me: What does it mean to you to run a “neurodiversity-affirming” practice?
JS: First and foremost, it means not assuming neurotypicality (that they are non-autistic, non-ADHD, etc.) from our clients. It also means that the environment is sensory-friendly. From the moment clients walk in, they will feel welcome. We have no painful lights, no extreme colors in the waiting room, and nice music that people can turn off at will if it is bothersome.
Second, we honor Nick Walker’s Golden Rule of Neurodiversity: “Respect the bodily, sensory, and cognitive needs of others as you would want your own to be respected, whether or not you understand the reasons for those needs.”
We allow people to explore the office space in their own stimmy ways and make changes to maximize sensory comfort. In our offices, we offer varieties of light environments, stim toys, blankets (weighted or not), jars with pleasant scents, etc.
We do not mandate eye contact or sitting still. We will go a local botanic garden or walk outside if needed. Clients can pace, stim, jump up and down, anything they want (within reason) in order to make our therapy hour a place that can best meet their needs and allow for their authentic being to shine.
Finally, we focus on phenomenology over pathology – that means we feel psychological health is about understanding our own subjective experience and maximizing authenticity and meaning from our own point of view, rather than imposing a Neurotypical point of view on others.
Me: You keep mentioning stimming. What does that mean for those who are unfamiliar?
JS: Stimming is short for self-stimulatory behavior. It’s repetitive behavior– often movements, making sounds, or repeating phrases– that helps to keep the nervous system regulated. All people stim, at least sometimes. This can be obsessing over a thought, counting things to stay calm, twirling a lock of hair, bouncing a leg when sitting still, or rubbing their hands together.
Neurodivergent people just tend to stim more often and in more obvious ways, sometimes by pacing, rocking back and forth, or flapping their hands. When therapists ask their clients to sit still or to repress their authentic selves, they’re setting the tone that the client can’t let down their guard and that their needs are something to be ashamed of and hidden.
During therapy, I often have stim objects readily available and as a neurodivergent person myself, I find that stimming along with my clients really opens us both up to feel better connected. I urge other therapists to join with their clients in stimming and try to discover the joy in it. When someone can really zero in on little differences and use their senses differently, it can create discovery, joy, and solidarity.
Me: How did you come to develop a Neurodiversity-affirming practice?
JS: Necessity is the mother of invention. I run the practice with my wife, Brittany Bovee Schwartz, LCSW. Our entire family is neurodivergent. Because we naturally do things differently and have little patience for Neurotypical bull and unjust institutions and systems, it was either create something that worked with our strengths and oddities or slowly burn out as our intense passions were extinguished.
I, personally, as an ADHDer and trauma survivor, have particular anger at unjust institutions. Since the beginning of graduate school, I’ve been somewhat of a critic of conventional therapy practices. I’ve been an outspoken opponent of the medical model, one-size-fits-all manualized therapies, and forced medicating and hospitalizations. I recognized very early on how coercion and violence can easily be enacted by well meaning practitioners, and I vowed never to go down that road.
Me: I see your practice is called Total Spectrum Counseling. What makes treatment with Total Spectrum Counseling different than typical therapy?
JS: Frankly, when Brittany and I have been in therapy ourselves, we have found the experience to be boring and uninspiring. When the rules of engagement are thoroughly centered on neurotypical ways of being, we haven’t felt comfortable truly opening up and being ourselves. When we have, we have often perceived an air of judgment.
Either that, or therapists have been so fascinated with us, that we became curious oddities instead of people with our own needs and experiences. Also, and I recognize that this sounds a bit self-aggrandizing, but because we conceptualize things in a deeper and bigger way, we often feel we like we are three steps ahead of our therapists. My last therapist was also an ADHDer, and it was a welcome change of pace.
Me: So, in what ways are you– and other neurodivergent clients– different from neurotypical clients? How are you different from neurotypical therapists?
First, our clients don’t have to spend time explaining neurodivergence to us because we get it. We understand it from a first-person perspective and from the perspectives of countless other neurodivergent people whom have educated us with their lived-experience.
Second, because we do not expect neurotypicality, we have a hell of a lot of fun. We stim along with our clients, creating weird things together out of the array of stim toys. We delve into intense interests with our clients. I have personally been introduced to a whole world of awesome pop culture and nerdy oddities by my clients. We don’t require clients to stay on topic or urge them into societal compliance. We strongly validate neurodivergent experience and celebrate it.
Third, we understand that much of the difficulties our clients face are due to trauma and exclusion, not because they are different. We do trauma work with quite a lot of our clients and help empower them to find communities of care that accept them for who they truly are.
We work with families to accept each other instead of shaming each other into neurotypical ways of being. Finally, we offer distance and teletherapy to those who are uncomfortable making the trip to our office or are limited by other disabilities.
This has really come in handy now that we are all practicing social distancing due to COVID-19.
NC: Speaking of which, do you have any advice for families that are isolating due to the current pandemic?
Yes. This goes back to Nick Walker’s Golden Rule of Neurodiversity – “Respect the bodily, sensory, and cognitive needs of others as you would want your own to be respected, whether or not you understand the reasons for those needs.” Already, we are seeing competing sensory and energy needs creating conflict in the families we serve.
Those of us who have family members who are highly sensitive, ADHD, Autistic, psychotic spectrum, bipolar spectrum, etc are experiencing conflict as all of our sensory, energy, and social needs are clashing. It is essential that these needs be addressed before they create strife that can trigger terrible psychological experiences and/or emergencies. We have just begun offering brief family coaching worldwide to meet this need.
We create a space to talk non-judgmentally and openly about clashing needs so that families can prepare to care for each other in these oft neglected ways and avoid psychological crises.
It was a delight to interface with Dr. Schwartz about his experience and practice, but it also caused me immense sadness for what most neurodivergent people experience when seeking mental healthcare supports. I personally have had to explain what it means to be an adult autistic person to every therapist, my psychiatrist, and even medical doctors.
This means that I come off as pedantic to them, but the information is critical to their ability to treat me. Sensory overwhelm can’t be treated like depression or anxiety, or me just being overly sensitive about my preferences.
I am unintentionally gaslighted every time I try to explain why things are different from me than for other people, or how very much they affect me.
I can imagine that if we all had access to providers like Dr. Schwartz and his wife, we would be much more self-accepting, happy, and well.