Een vlag voeren die Neurodiversiteit viertjuli 20, 2020
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At the end of an initial consultation I ask clients “what are your goals for therapy”. It is at this point in time that I can feel my mind racing and heart pounding with excitement as there are so many things my mind wants to communicate. I take a mindful seat and feel the privilege of witnessing a journey that begins.
The Impact of Avoidance Behaviours, Repression and Masking and the Way Forward:
The diagnostic and statistical manual (DSM-5) differentiates between feelings, thoughts, physical sensations and behavioural urges or actions. Diagnosis feels less threatening when we remove judgement and curiously observe the mind repetitively returning to a destination, and the urges or actions that may follow. For example, Major Depressive Disorder may result in the mind continually returning to an existential headspace (what is the meaning of life, who am I connected to, what do I create in life?), which may lead to overwhelm and adversely impact day to day functioning (I.e., mood, sleep, appetite, memory, concentration etc.). Generalised anxiety may result in the mind focusing on what is outside of our control and lead to an urge to seek reassurance (regarding the likelihood of feared outcomes).
Learning healthy ways of sitting with distress Involves gaining an awareness of the common triggers of distress and understanding the warning signs that signal that we are experiencing distress. Once you become aware of your triggers and warning signs, you are in a better position to apply helpful coping strategies. A structured, research-informed learning experience promotes both positive and sustained growth.
Schema Therapy is a powerful treatment approach that allows people to identify psychological defences and self-defeating patterns that begin early in life. Cognitive-Behavioral Therapy and Dialectical Behavior Therapy provides coping skills to challenge problematic cognitions (thoughts) and behaviours that can amplify distress. Learning to be mindful of your emotions in a curious and non-judgmental manner (Acceptance Commitment Therapy) allows clients to change how they pay attention to an emotion and sets the framework for managing distress in a healthy way. Dr Bruce Perry’s model of Sequential Engagement and Processing (regarding brain states), is highly impactful to teach clients how to regulate (self soothe) and relate (with emotional attunement) before attempting to reach the learning part of her brain (which is futile when people feel dysregulated and disconnected). Exposure Response prevention therapy is a process of confronting fears until they subside (the process of habituation). Perceptual shifts allow people to center the mind and body and direct their emotional energy and cognitive capacity towards what provides one with meaning, connection and creativity.
Neurodivergent individuals are acutely aware of their differences energetically, physically, emotionally and mentally. Many clients block their emotions and mask (camouflage) due to societal discrimination and a lack of accommodations designed to meet the neurocognitive needs of neurodivergent minds. An important first step to removing the mask is one of acceptance, before we can identify and embrace the many strengths and beauty of neurodivergent minds. When we can come to accept our whole selves, we can remove the mask that makes us feel hidden, rejected and disconnected.
Repression of emotions and masking (suppressing your natural way of existing and camouflaging), may lead to burn out, disconnection and isolation. Whilst it is important to teach people about refraining (holding back), repression has a different energy in which you are afraid to express your emotions or feel the need to suppress your natural way of existing. To refrain is a healthy response, rather than a reaction, that is a choice rather than a requirement. It is important that clients feel safe enough to reach out for help, before they reach breaking point (develop maladaptive thinking about their plight), and believe that they have utilised all-of the responses in their coping repertoire (including seeking help).
You don’t grow out of the way your mind works, rather you grown into it. A great tragedy is going through life disconnected from our brilliant minds, because we see the self as broken. The theory of a Functional Legacy Mindset approach is grounded by the therapeutic benefits of embracing the authentic self, to promote a sense of purpose, in which clients feel empowered to embrace their unique strengths and abilities. The assumptions and narratives that dominate different minds play an important role in the mental health and wellbeing of our clients.
Please see below a mental fatigue diary (a further elaboration would be to perform a task analysis individualised for the client), that has helped a client with ADHD apply self-compassionate thinking and accommodations.
Mental Fatigue Diary
Source: Dr Kerry Chillemi
The discipline of psychology is evolving at a rapid pace. There is a move away from the idea that people need to meet neuro-normative expectations in-order-to successfully succeed in life. When you build a healthy self-concept, clients are eager to learn and are more likely to develop a self-compassionate mindset that acknowledges that support is vital and needed. The ripple effect of these powerful minds benefits many people for years to come.