Reflection · Neurodiversity
Adapting psychodynamic practice for neurodivergent clients
More adults are coming to therapy having recently recognised themselves as autistic or ADHD. Some of my usual methods need rethinking, and some need only explaining.
Training in autism and ADHD has changed my practice less than I expected in principle, and more than I expected in detail.
Silence and ambiguity
The classical psychodynamic stance leans heavily on open space. For some clients that space is not fertile, it is simply unclear. I am more willing to be explicit about what we are doing and why, without giving up the frame.
Rethinking what I am seeing
Behaviour I might once have read as resistance or avoidance is often regulation: masking, exhaustion, difficulty with transitions. Reading it accurately matters, because reading it wrongly repeats something the person has met all their life.
The work that remains the same
Grief for an unrecognised earlier life, anger at being misunderstood, the exhaustion of performing. Those are psychodynamic themes in the fullest sense, and they respond to being taken seriously over time.