The myth is everywhere, and I’m frightened, really frightened of the implication of this cultural lie and what it means for me, the people I love, and most of my clients.

This blog seeks to unpack the lie, why it’s happening right now, what it means to want to push back on an empowered, visible and understood neurodivergent community.

Me and Hannah Gadsby

I’m currently listening to Hannah Gadsby’s autobiography. Gadsby shares how she, like me, came to diagnoses of autism and ADHD late in life, and how hard her life was before these diagnoses. I recommend reading it to understand how someone who seems on the surface to be coping with life may be struggling more than we know. Gadsby also points to how she was previously misdiagnosed with personality disorder, how the trauma she incurred because of being different led to clinicians mistaking her neurodivergence for cPTSD, and how it was a therapist who helped her understand she was AuDHD, although that wasn’t who clinically diagnosed her. When she was diagnosed, she experienced backlash and disbelief, based on the idea that she didn’t have things “bad enough” and she didn’t appear “autistic enough”.

Gadsby’s story is so emblematic of the typical story I hear in the therapy room every day, I’d suggest reading it is an excellent CPD on the subject. It’s also very close to my own story.

I look back at my life now and think how different things could have been for me. People are suspicious of my AuDHD diagnoses, even though I’m fortunate enough to have been able to access NHS diagnoses for autism and ADHD, but people look at me and externally see someone who manages “just fine”.

What people don’t see when they look at me

I could have been read by secondary school as a “successful student”, although in primary I was seen as “behind” and “slow” and a “daydreamer”. Later, being interested in school masked my struggles; I never figured out how to self-study, but I could pass exams by cramming and write essays on the school bus and get away with it. I began to struggle academically as being able to organise myself became increasingly necessary. Then CVs, interviews, application forms, and even opening a bank account were completely inaccessible to me, so I didn’t apply to university, but instead got cleaning work by putting hand-written cards in local shops. This despite tutors recommending I apply to Oxbridge.

I was terrible at cleaning work because I couldn’t organise myself, am relatively time-blind and I was highly distractable when bored, but at least I didn’t have to talk to people or be forced to sit still in an office, my worst nightmare. I did that work for seven years, chopping and changing clients regularly, with a bit of farm labouring thrown in.

Being different and socially marginalised led to me experiencing some hefty traumas as a child and young adult, including a period of homelessness. I won’t go into detail here, but those traumas were later used to “explain” the traits I already had, pre-trauma, and that I can see throughout my entire family. Difference became pathology that needed to be healed rather than accommodated. I was a problem to be fixed rather than a human to be understood.

I dulled my “over-sensitive” senses with drugs and alcohol for years to cope. I surrounded myself with other “dysfunctional” people, all of whom I now realise were likely also neurodivergent. Six of my friendship group died by suicide and many more have been lost to addiction.

I got to university in my late twenties because my then partner took me by the hand and sat me down with his mentor, the chemistry admissions tutor of a red brick university, bypassing any application process (a privilege; it really is who you know). I got an A-grade chemistry a-level in evening class whilst working 6 days a week cleaning (autistic hyperfocus for the win!) but my health started to crumble that pre-uni year, and I had to give up doing such physical work. My prospective place at university and a newfound very basic IT literacy got me a job as an office gofer, with some night work in factories on the side.

At university I came top of the year in one module and second in another in my first year in one of the top Chemistry departments in the country after 6 years of scrubbing floors and addling my brain with drink and drugs. They talked about me doing a PhD. But I couldn’t find my way into some topics and floundered. I nearly failed one subject memorably because I didn’t know how to ask a very basic question to get me started on the coursework, so I just didn’t submit it. To the outsider I likely appeared feckless, but things mattered so damn much to me, I just didn’t know how to do very basic things others took for granted, and it was inconceivable to folks that I might be struggling because I masked my distress so well, coming across tough as nails.

My sensory sensitivities made my favourite topic, organic chemistry practicals, inaccessible to the point I could barely stay on my feet through them. My health was getting crumblier, and looking back I must have been experiencing burnout from so many of my access needs not being accommodated.

I didn’t complete my degree because in the end I experienced chronic fatigue and burnout so bad my physical health never fully recovered. When neurodivergents get to this point, it can change our lives forever – it simply shouldn’t happen.

My personal tutor thought I should just pull my socks up and stop being lazy.

My fibromyalgia wasn’t diagnosed for another ten years because doctors back then didn’t understand neurodivergent people have problems with collagen synthesis that can lead to myriad physical health issues that are exacerbated by stress. Therapists told me I was just traumatised and it was all in my head.

Recovery and a liveable life

I fell into counselling training going to evening classes after a period of being unable to work, barely able to get out of bed, walk, function. I endured the inevitable scapegoating nearly all AuDHD people experience in therapy training to qualify because finally, I could see a work situation that was low sensory, one-to-one, utilised my highly empathic, highly sensitive nature and was accessible to me!

When I tried to get diagnosed as autistic years later, the assessor thought I couldn’t be autistic because I’m empathic (a now debunked but popular stereotype). I in fact think there is a high amount of AuDHD in our profession: we make good therapists. I’ve connected to many fellow AuDHDers through Counsellor Staffroom, a safe place for neurodivergent therapists.

I now only have a successful business because of accommodations I make for myself and get through Access to Work that are specific to me being AuDHD and living with a growing list of long-term chronic health conditions. I still often have to sacrifice any kind of a social life because I use all my spoons for work and on bad days am crawling into bed whenever I can through the day.

Despite having been deemed once upon a time “Oxbridge material” I am 54, don’t own a home, or a car, and my student loans were written off at age 50 because I never earned enough to pay a penny of them back.

When I wrote my very well-received book, Person-centred counselling for trans and gender diverse people: a practical guide in 2018, most of the rest of my life fell by the wayside, a last-minute hyperfocus in which I put the work through in an astonishingly short time but at huge stress. Not an experience I’m rushing to repeat, but one that brought me the ongoing satisfaction of knowing I’d produced something I can be proud of that is out in the world hopefully doing useful work. I could not have done that without insight into my disability and support.

If you look at the surface of me, you might see a quite together person who runs their own business and has a reasonable profile. You might see someone who copes very well. And I did start to cope, become independent, manage on my own and not depend on sometimes unsafe relationships, when I got a diagnosis and started to consider and ask for accommodations. But even the neurodivergent folks who appear in many ways to be thriving, are facing hidden costs to our nervous systems and long term health if not being given enough adjustments.

Why does it seem like there are more AuDHD people?

My story and Hannah’s point to one answer: autism and ADHD were poorly understood and massively under-diagnosed in anyone who wasn’t a white, cis male. It’s all very well invoking the power of “experts” to diagnose us, but the problem with neurotypical experts was that they were theorising from a place of bias, basing their ideas on external behaviour rather than internal experience, and as a consequence, the vast majority of psychological literature on autism and ADHD is purely and simply wrong. For example:

• Some of the most popular autism tests have a strong gender bias, rely on autism stereotypes, ignore the patient’s self-experience and are based on the now much debunked “extreme male brain” theory, leading to the false conclusion that autism is more prevalent in boys [source].
• Until recently, it was wrongly believed that ADHD doesn’t occur in adults and cannot co-occur with autism, so no autistic person or adult was able to seek an ADHD diagnosis. As a result, the only time ADHD was diagnosed was when it presented as stereotypical disruptive behavioural issues in boys at school. AuDHDers like myself, who were relieved by the structure of school and found it interesting so were able to hyperfocus (as I still can with clients or when I’m training or writing), were missed, and when ADHD showed up more in adulthood, well, nobody was looking for it.

But maybe the people who most needed it were getting diagnoses? Well, tell that to my dead friends. In fact, diagnosis in childhood has in the past tended to be stigmatising and unhelpful, because autism and ADHD were so poorly conceptualised and pathologised. The neurodiversity paradigm has revolutionised this – it sees differences rather than deficits, and the need for flexible approaches from those around us rather than focussing on how to change who we are.

When I work with my traits and accept them, I thrive. Much of my past turmoil was around living up to arbitrary neuronormative standards. For example – counselling courses stress the importance of client eye contact, which for me when I’m talking about myself is sensorily overwhelming (less so when I’m listening). This often gets interpreted as shame or dishonesty or lack of engagement but it is simply a feature of a monotropic brain that cannot do too many things at once – eye contact is, for many autistics, a more intense and overwhelming experience. Lack of eye contact is often interpreted in ways that unnecessarily downgrade our social skills and cast us as uninterested. We may get socially rejected, suspected or dismissed because of neuronormative assumptions. Just one tiny example out of so many.

Here’s what happens to people when they aren’t empowered to ask for the accommodations they need to thrive, regardless of diagnosis:

• An estimated 25% of the prison population have ADHD, largely undiagnosed.
• Substance use: 21% have ADHD. Again mostly undiagnosed, I was one of them.
• Higher rates of homelessness in ADHDers. Again, I was a homeless teen.
• Many people with Borderline Personality Disorder diagnoses meet the diagnostic criteria for autism [source].
• Autistic people have a higher rate of suicidality, regardless of other factors.

Underemployment, extra stress leading to more autoimmune issues in bodies that already have a much higher rate of connective tissue disorder and numerous physiological differences related to collagen synthesis, more trauma due to workplace bullying because of poor understanding and scapegoating. And so on.

In whose interests is it to resist accommodating us?

Make no mistake, the rhetoric that abounds at the moment isn’t a bid to save the public purse – it’s in the interests of the economy and the budget to not have us in prison, or struggling with long-term unemployment, unsupported ill health, burnout, addiction or homelessness. Stress is such an impacting factor on autoimmune issues and mental health, we will be less burden on the NHS if we’re supported, understood and allowed to thrive, and we will also be more likely to be in work and off benefits.

But at a time when society is becoming increasingly unequal, when privitised healthcare is stalking us, when we are being sold the idea that there are people we cannot afford to care about, and when so many people are struggling, it is seductive to scapegoat and exclude certain groups, easier to say folks need to just pull their socks up than imagine a world where we accommodate difference, even if autism and ADHD-friendly accommodations often make life easier and more pleasant for everyone.

Although everyone is happier in a more equal society, the game being played here isn’t about happiness, it’s about winning. Undiagnosed, unempowered neurodivergents are tailor made to be capitalism’s cautionary tale, among its favourite scapegoats, especially when our identities intersect with other marginalisations. If autism and ADHD diagnosis is no longer only for middle class white boys, it could disrupt existing, built-in social inequity.

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