Listening to the unspoken

“Kill yourself!” The client repeated this countless times throughout our counselling session. This tic had been observed and discussed as evidence of the client’s experience of tourette’s syndrome, and now neither of us bothered reacting to its presence. Instead, it functioned as an indicator of the client’s stress level – utterances would increase as we entered a more emotionally charged discussion, or dissipate as the client relaxed.

Society has expectations for how to live, and those who don’t know how to fall in line often pay a price. The emotional and mental toll of feeling misunderstood, of repeated disappointments and the growing pressure to “get it right” can become debilitating at times.

Another client – a youth with genuine kindness and enthusiasm for life – used his chair only as a suggestion for where his body should remain. Our sessions were punctuated by regular stretch breaks, jumping jacks and unrelated (though often highly entertaining) stories. I watched him struggle against his body to follow relaxation-based exercises until we finally found rhythmic movement grounding exercises that suited him better.

20,000 negative comments

The neurodivergent classification includes many diagnoses but is particularly associated with autism spectrum disorder (ASD), attention deficit disorder or attention deficit hyperactivity disorder (ADD or ADHD), Down syndrome and various sensory disorders and intellectual disabilities. These frequently co-occur with other diagnoses, making each individual’s experience highly complex. The 2019 Canadian Health Survey on Children and Youth found ASD present in “1 in 50 . . . of Canadian children and youth aged 1 to 17 years.”

ADD or ADHD “is one of the most common neurodevelopmental disorders in Canada,” reported the Centre for ADHD Awareness Canada earlier this year, “affecting 4-6 percent of adults and 5-7 percent of children, or approximately 1.8 million Canadians. In other words, 1 of every 21 people in the country has the disorder.”

Negative side effects of neurodivergence can include difficulty interpreting social cues, oft-interrupted thought patterns, struggles with coordination and more. On the flip side, those on the spectrum can possess strengths such as increased creativity, the ability to hyper-focus and impressive attention to detail.

Societal responses to these strengths and weaknesses vary – being passed over for jobs, not being invited to social gatherings, even direct name-calling or bullying. Michael S. Jellinek (2010) shows how symptoms of ADHD can impact a child early on:

“Picture a child with attention-deficit/hyperactivity disorder (ADHD) in school, doing what kids with ADHD do: fidgeting, blurting out answers, jumping out of the chair, or zoning out because of some distraction during the science lesson.

It’s not too much of a stretch to assume that such a child might receive a negative or corrective comment from the teacher, say, three times an hour “Pay attention!” “Sit still!” “Get back on task!” Let’s say the child is in class six hours a day for 180 days of school each year. That’s more than 3,200 nonpositive comments directed at a child each year and does not include a single annoyed comment from a coach or an angry scolding from a parent.

In school alone, a child with ADHD could receive 20,000 corrective or negative comments by the time he or she is age 10.”

The experiences of those living with neurodivergence often create a need for therapeutic support; it is a frequent presence in the field of mental health.

What about me?

As awareness of neurodivergent diagnoses becomes more widespread, people often wonder if they, their relatives or friends could belong on the scale. This process often begins with an acknowledgement of their own symptoms, then expands to memories of relatives who struggled to hold down jobs, never finished school, cycled through multiple relationships or went through life with little or no community. It can be tempting to assign labels to family members; in one session, we discussed the potential of a client’s husband having autism, mainly due to her frustrations around him not sharing her sense of humour and showing a lack of creativity when they had sex.

Self-diagnosis is common but rarely advisable, and occasionally even offensive. Pursuing an official diagnosis is challenging; for example, those with ADD/ADHD are often diagnosed between ages six to twelve but must provide evidence of symptoms before this age from multiple spheres of life (personal life, school, healthcare, professional) to qualify. This process often includes a visit to a doctor, a referral to a specialist and multiple interviews and observations. Those with a diagnosis become eligible for financial aid from the government and school supports, but often face roadblocks in finding available services. Other children show plenty of symptoms, but not enough for diagnosis; these families struggle with the knowledge that being tested on a “good day” instead of a “bad day” means they won’t have access to services. A diagnosis can provide answers for parents of children who show neurodivergent symptoms, but often it is simply the end of the beginning (pre-diagnosis) and the beginning of more questions and challenges.

Those experiencing symptoms of neurodivergence deserve respect and compassion. We can use our own experiences to imagine what a day in their life could be like. Consider – when have you not known what to say in a social situation? Has your body ever done anything embarrassing in public that you didn’t see coming? Do you struggle to focus at times? If you are a parent, has your child ever had a meltdown in public? We are all human, and it is this humility that we can carry into our interactions with those around us.