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Unsafe, Unheard & Misunderstood: Trauma & Neurodiversity

 

Many times, traditional trauma viewpoints do not fully capture the experience of neurodiverse learners resulting in many children and adults being misunderstood and many underlying needs overlooked. 

The following blog is based upon my collaboration with my good friend and colleague, Kim Clairy MS, OTR/L who is autistic. We often do live online courses and in-person trainings on this topic among many other topics. You can learn more about Kim at www.kimclairy.com

 

Trauma is a hot topic that is thankfully getting a lot of attention in research and practice right now. The importance of trauma-informed care has become evident in its positive impact. Therefore as therapists, our practice should include a solid understanding of trauma and the influence that it has on the brain and body of our clients. 

Trauma is a response to an event or series of events that causes someone to feel unsafe, threatened and/or severely distressed. Traditional trauma viewpoints typically define a set of common events that may result in trauma such as abuse, neglect and household dysfunction. However, each person experiences life events differently, and the exact same event may be traumatic for one person but may not be traumatic for the next. In other words, trauma is dependent on how each person experiences or responds to an event(s). Therefore, each person’s unique responses should always be considered and validated.

Unsafe, Unheard & Misunderstood: Causes of Trauma from being Atypical Living in a Typical World

Many neurodivergents report trauma responses from living in a ‘typical-focused’ world and it is imperative that we begin to think beyond the traditionally defined causes of trauma and consider causes that are not typically considered within traditional trauma frameworks. 

These include trauma from:

Cause 1: Sensory Trauma
Sensory Overwhelm & Learning to Hide Sensory Needs

Many individuals that experience sensory differences, report that the world can feel very overwhelming, unsafe and threatening. For example, auditory sensitivity can cause certain sounds like the sound of a leaf blower, fire alarm or person chewing to be extremely painful and insulting to the nervous system, often causing an extreme stress response. To some without sensory differences, these sounds may seem rather benign, but to a person that has sensory differences, living with these daily sensitivities causes trauma from the repetitive experience of feeling unsafe and fearful. To make matters even more distressing, many times these sensory differences are not validated and/or accommodated by others and many neurodivergents learn to hide or mask their sensory needs in an effort to please other people or fit in. This can compound the feelings of overwhelm and threat because the person doesn’t feel free to do things that may help them cope with their sensory sensitivities and feel safer in the world. 

Cause 2: Social Trauma
Bullying, Isolation, Feeling Different & Masking 

The degree to which neurodivergents experience bullying and isolation tends to much higher than the general population and it is generally acknowledged that bullying and isolation can be a cause of trauma. However, the social traumas that are not typically discussed, but affect many neurodivergents, include the experience of feeling different from others. Especially at younger ages neurodivergents often report that they did not understand why they felt different—for example, why they just couldn’t seem to fit in or why they couldn’t seem to keep up with or why they didn’t think like many of the others around them. Neurodiversity or straying from the ‘behavioral norm’ is not generally celebrated in our society*—therefore leaving many very talented, smart, creative and unique thinkers to feel less than, not good enough, and severely distressed thus leading to trauma. Furthermore, in an effort to fit in, please others, earn reinforcers, many neurodivergents mask their true selves, almost losing a part of who they are as a person which of course can compound the trauma experienced. 

*Thankfully there are strong neurodiversity movements emerging to make things better…but we certainly have a way to go!. 

Cause 3: Compliance Trauma
Dangers of Normalization & Surface Behavioral Approaches

Unfortunately, many neurodivergents have been victims of compliance and normalization approaches. As mentioned in Cause 2, neurodiversity or straying from the ‘behavioral norm’ is not widely accepted and approaches to normalize neurodivergents are rampant in our field. Take for example some of the social skill programs which often have a focus on how to ‘act’ in a ‘socially acceptable or typical manner’ in order to give others ‘good thoughts’. Of course it is always good to be kind, however, many argue that these social skill programs can be extremely judgmental–who gets to determine what is ‘socially acceptable or typical behavior’ anyways? 

Furthermore, many neurodivergents experience extreme stress responses which are sometimes mislabeled as ‘challenging behaviors’, which in turn often lead to use of behavioral approaches driven by compliance and ‘fixing’ the ‘observable, challenging behaviors’. These compliance approaches only view behavior from the surface and fail to acknowledge, investigate and understand the true underlying causes of why a person may be struggling to thrive in their current environment. Failure to understand the underlying reasons, often leading to the use of traumatizing supports that strive for compliance via the use of external methods of control such as reinforcement, punishment, planned ignoring, or withholding of interests until they are earned. 

Cause 4: Neurological Trauma
Communication Differences & Dealing with Uncertainty

As the name implies, Neurological Trauma can occur from various neurological-based variances such as communication differences and overwhelm from uncertainty. For example, when a person has difficulty communicating important needs, desires, thoughts, ideas, questions, etc. it can result in feeling misunderstood and unsafe, which can result in trauma. Even for neurodivergents that are conversational and typically talk to communicate, when overwhelm or anxiety strikes often their ability to communicate in a way that is understood by others can be drastically affected. In addition to communication differences, navigating uncertainty can be very distressing for many neurodivergents. This is why they often strive for predictability, repetitiveness and need for sameness, but then are often mislabeled for being rigid and inflexible when in fact it is their effort to make their world feel as safe as possible. However, we all know that despite our very best efforts life can still be very uncertain resulting in many that experience trauma from a rapidly changing world.

Cause 5: Medical Trauma
Being Misunderstood by Medical & Mental Health Providers

Numerous neurodivergents report distressing experiences when navigating both medical and mental health appointments. Much of this distress stems from feeling misunderstood, unheard and unaccommodated by providers. Neurodivergents can present medical or mental health needs that may stray from the norm, however, most providers attempt to meet their needs with the cookie-cutter approach that is designed for successful treatment of the masses–rather than an individualized approach that acknowledges and accommodates neurodiversity. To be fair, most providers do not have adequate training in understanding and supporting neurodiverse patients. Some want to do well, but do not know how to provide a successful appointment process. However, according to the report of neurodivergents, other providers refuse to see and accommodate for the neurodiversity (even when it is requested). In both situations, it causes mistrust in providers and distress over appointments. 

Practical Strategies for Trauma + Neurodiversity

Countless neurodivergents have been subject to many of the aforementioned causes of trauma and have thus experienced the long-term detrimental effects of these traumas. In our Unsafe, Unheard and Misunderstood course, Kim and I teach many practical, evidence-based strategies that help to prevent and/or nurture healing from trauma.  These strategies are applicable in supporting learners of a variety of ages, backgrounds, diagnoses & learning styles. Hopefully, we will continue to expand our knowledge regarding the common trauma experiences of neurodiverse learners and enhance our ability to better support these needs in the learners we serve.