Latest / The STA Clinician Podcast / Ep.270 'Neurodivergence in Healthcare - Part 3 of 4: Barriers'

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Ep.270 'Neurodivergence in Healthcare - Part 3 of 4: Barriers' · The STA Clinician Podcast

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You're listening to the STA Clinician Podcast, connecting clinicians across healthcare.
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Named STA Clinician Podcast, formerly known for the last five years as the Sports
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Therapy Association Podcast.
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My name is Matt Phillips, and I'm creator of runchecklive.com.
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And as always, this episode is being recorded live on the Sports Therapy Association
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YouTube channel and Facebook page on a Tuesday night at eight o'clock.
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You join us for part three of our Neurodivergence in Healthcare series in January 2026,
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with the goal of providing valuable information to help soft tissue therapists
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work closer and more effectively with neurodivergent patients and clients,
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and also provide suggestions for neurodivergent therapists on how to monitor
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and care for your good selves.
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Right then, so in this episode entitled Barriers, we're going to be looking
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at the barriers that neurodivergent patients and clients so often find themselves
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up against when seeking healthcare, which typically reduce their access to effective
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or suitable healthcare.
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I'm going to be joined very shortly by my very special guests,
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my very patient special guests.
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James Dewa Haggart, founder of StrongPath, neuro-inclusive and mental health-informed
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sports coaching, website strongpath.org.uk.
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And also the lovely Leslie Campbell, a massage therapist and tutor,
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and tutor, based in Glasgow, Scotland, website lesliecampbellmassage.co.uk.
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Firstly, before we jump into that, a huge thanks to my guests in part two last
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week in episode 269, which was entitled Hypermobility and Neurodivergence,
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namely Bonnie Southgate, MSK advisor at CEDS Connective.
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Jess Yannerman, advanced clinical massage therapist at Ease Therapies,
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and Rosie Sexton, osteopath at Alton Health and Performance.
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It was, as always, I always say this, but it was a really amazing episode,
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hugely informative, that looked
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at the current research which links hypermobility and neurodivergence.
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It considered the diagnostic challenges, individualized treatment strategies,
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patient experiences of validation, how to dose exercise safely,
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so much information and tweaks which you, the clinician, can make to help listen,
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identify, modify treatment, and refer to specialists where necessary.
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So that's episode 269 of the Yesterday's Clinician podcast, available now on
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all popular platforms and on YouTube.
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And just before we bring up tonight's guest, if you do identify as a neurodivergent therapist,
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whether through formal diagnosis or not, then you are very welcome to join our
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new private Facebook group, Neurodivergent MSK Clinicians, which is a safe,
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non-judgmental space to share, support, chat, or just listen.
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Search us up on Facebook and you will find us. Please remember to answer the
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group questions when you ask to join right then.
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Here we go. Five minutes ago, we thought this was never going to start.
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It's episode 270 of the STA Clinician Podcast, Neurodivergence in Healthcare
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Part 3, Barriers, with special guests James Dewar-Haggett and Leslie Campbell.
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I shall now bring them up.
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For people who don't know you guys, which I'm hoping a lot of our listeners
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don't know you, James and Leslie, could you introduce yourself?
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James, maybe first of all, a little bit about where you are what you do where
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you are in the country etc yeah so my name's james 43 i was thinking then it's
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all the stuff that's gone on the forum sitting here and i'm a brain scramble,
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i've just asked you because i need a rest that's probably selfish reasons,
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got it i've got it so yeah my name's james i
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oh so i used to be maybe
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still i am a personal trainer or a soft tissue
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therapist more recently in the last few years i've uh
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a bit like matt i'm a i write
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accredited courses and i was uh i wrote the
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with autism and a lovely lady called dr ruth moise i wrote the first accredited
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sports coaching course to work with autistic people in the uk and that was accredited
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by simsmar i also work with the nhs and everyone's uh projects with things like the EIP,
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so an intervention for psychosis, work on studies.
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Yeah, a bit of a real mixed bag. I suppose, you know, there's that magpie in
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me, which I'm sure a lot of people can, you know, connect with.
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So, yeah, lots of different projects, all the time.
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Amazing. Really appreciate the time you're giving us. James, thank you very much.
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And Leslie, for people who don't know you, for the few people on the planet
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have not marveled at your antics, tell us about you, Leslie.
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So I'm a massage therapist. And I started to,
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really exploring my ADHD a few years ago, which led me to applying for access to work.
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So that's my first nugget. If anybody on here is neurodivergent or has a client
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who has disclosed they've got neurodivergency and they're struggling at work.
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You can apply for funding and assistance from access to work.
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And actually the form is really straightforward and you can apply whether you're
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diagnosed or not diagnosed.
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And I was lucky enough to be bolshy enough to keep pushing that I got awarded some funding.
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And I ended up with an ADHD business coach, which is way more than just business coaching.
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And over my conversations with my coach from Access to Work,
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I realized that probably a diagnosis was going to be really quite positive for me.
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So at the grand old age of 55, 56.
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Jesus I'm 56, at the grand old age of 56
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I got diagnosed last year with ADHD and that's the other thing that I would
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add that my menopause made my ADHD symptoms go tonto and the ADHD diagnosis
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has been really really actually really important for me,
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I didn't really realise how important it was going to be until I got it
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and now I feel much more confident about advocating
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for myself in different situations and all sorts
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of situations now that I can say I've actually
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got ADHD rather than well I might
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have ADHD and so I find it much
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easier to advocate for myself so that's
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me and I have been regulating my nervous system all day
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because of this has been on and until
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you started at quarter to eight and then i totally
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relaxed you didn't i yeah that's what i do it's what i do i am the relaxer thank
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you leslie amazing yeah i must apologize for the a few people saying this a
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bit crackly and i'm doing it i like talking about showing your age max max max
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max headroom yeah max headroom i'm doing a little bit of that as well i don't know why it's just all.
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I'm not going to even go about the week I had, but it's just fitting.
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It's a fitting end to a fitting week. But anyway, we're fine.
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We're all together and we're going to delve into a really interesting topic
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tonight. So thanks guys for joining us.
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Like I say, if you've got questions, people, you want to share stuff,
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then please do so. That'd be great.
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So barriers then. I thought maybe we've talked about communication already.
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It's come up in the first and second episodes.
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So I wonder whether you guys have anything to add about communication that we
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haven't talked about already.
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Because obviously that is probably one of the initial barriers when it comes
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to either emailing initially or when the person comes into the clinic what would you like to share,
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you're good james that's book last oh okay so
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i thought he was talking to the panel he said the panel and they
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go oh awesome someone's gonna ask a question and now i'm
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being clearly not very observant of me and staring
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into space because i don't really know what's going on and then so i
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suppose the most are we talking about communication yes in
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terms of communication i think that the biggest issue is
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probably something that's known as uh the double empathy
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problem so a wonderful uh scientist
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called damian milton it did a study
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years ago i want to quickly just point this out
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because i think a lot of people will really appreciate this i've watched
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damian milton speak at a conference and he
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very very briefly uh said that his phd he actually disseminated uh south park
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characters as his phd and as soon as i heard that he had taken south part characters
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and looked at their characteristics and all those things, I immediately fell in love with him.
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I was like, that is the coolest Pink HD I think I've ever heard of.
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My wife's done one, other than my wife's, all right, so before I get into trouble.
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But i just thought i would love to read that and and so it's a really really cool guy but he looked,
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communication and and and within that is he got
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groups of of autistic people and he got groups of
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neurotypical people and a bit like chinese whispers as far as i know i'm probably
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not doing it justice and and i'm sorry if i'm not but you know they were asked
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to communicate and you know they were to communicate certain things between
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the group and the autistic people they They were great. They were amazing. They did awesome.
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And then the neurotypical people, guess what? They were great. They were awesome.
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And they mixed the groups, all right, so that you had a mixture of neurotypical
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and autistic people, and suddenly there was an issue.
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There was a communication barrier in there straightaway.
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Now, whilst I would say that it isn't the neurotypical people's fault,
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and I'm going to say it's not the autistic people's fault, because there's no
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malice there. There's not, no one's trying to actively not, you know, communicate.
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There was clearly an issue where we communicate slightly differently.
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Now, if you can consider that 75% of the population are neurotypical,
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10% potentially, potentially, we don't know the real figures,
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but if Lorna Wing's right is autistic, we suddenly see that if you're a person who can't, you know,
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90% of your experiences are coming when people don't understand what you're
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saying or, you know, can't comprehend things, that's a big barrier.
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I suppose, I don't like making it like an us and them camp sort of thing,
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but for somebody who is neurotypical, okay, it's like a whole nother ballgame
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of, of, that you just don't know the rules of.
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There's an important thing to say about this as well, though.
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And that is that, in my experience, that, and I think this is really,
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really key, that whilst there is differences in communication,
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and there are, we are still speaking the same language. Yeah.
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So those differences are minor, if you know that there are differences,
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which is the most important thing out there.
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But I would also really like to stipulate that actually not feeling guilty and
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putting blame on either party isn't really important.
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And you did start with that, Matt, and I appreciate that you did.
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But I think that it's really important that, you know, one of the things I see
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a lot is that actually neurotypical people want to help.
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And they want to work with neurodivergent people
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and in particular autism in this case but actually
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they don't want to do it appropriately and positively
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and when in that situation that can be something that's quite quite daunting
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and probably quite you know nerve-wracking and actually one of the best things
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to do is just to ask the other person you know just sit there and and say to them, what do you need?
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And actually allow them to, you know, the person with the lived experience of
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what we're talking about here, the minority, fill that person in and just listen
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to what they're saying and try and facilitate what they're saying. And if you do that,
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I'm certain that the person, they see you making an effort, even if you get
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it wrong, they still want to really appreciate the fact that you made the effort in the first place.
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Yeah. I think that rolls into safety as well.
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Because, so in clinic, I think if you make people feel safe,
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particularly when you're neurodivergent, if you feel safe in an environment,
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you can relax and you can, you'll get, I feel like you'll get the best.
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And so with that one of the things that I do is that I have an optional box
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tick that goes out with my online form before they come and see me,
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And they can choose to or not choose to disclose whether they're diagnosed or not.
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And I've had quite a few folk will tick the box and say, yeah,
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we're a divergent, which then immediately made me get back to them by email. Don't phone them.
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I immediately go back to them by email and said, OK, that's great.
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Is there anything else that I can do to make your visit easier?
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One woman was like I am really I have
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really noises so she didn't want music
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at all another woman wanted a really unusual type
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of music but by starting that conversation
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it made them feel immediately safe when
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they came and and they then
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knew that they didn't have to do any masking and so when I was asking questions
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they didn't feel you know uncomfortable about
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it I think it's really interesting and it takes
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me back and I hadn't thought about this for quite a while but I
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don't know if it was like a couple of years ago but I was driving a car and
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I was listening to Radio 5 I think like BBC Radio 5 and I think it was Jeremy
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Varney and they were talking about the fact that well they were actually you
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know what let's give them kudos for it that a hairdresser would set up a.
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Sessions where you could you turn the hairdresser on booking whether or not
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you wanted to be spoken to or whether or not you did.
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And I sat and I went, ah, that's really cool.
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I don't like small talk, to be honest. I don't feel comfortable doing it.
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I feel like I'm masking. I feel like it's taking my energy.
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And actually, you know, if you're busy or you're in love, we can't reach that
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energy at that point in time to be able to disperse to that situation.
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The thing that really surprised me was the amount of people that came along and went,
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oh this well hairdressing it's all about talking to your hairdresser it's all
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about this and that and the other and i said i went well it might be for you
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but i'm just sit there and get my haircut and and leave from there and it was
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quite interesting the kind of.
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50 50 in terms of people saying they wanted it and they didn't want it but you
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know it's about having that choice of you know it's that it's that you know
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equity i suppose that is equity isn't it?
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It's choosing whether or not you want something, whether that's for you as a person. Yeah.
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And that's the other thing as well. I mean, I do this for anybody,
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no matter how they describe themselves, is explaining every single,
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I try not to make it long-winded, but describing everything in the consultation
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form that I'm going to do once they're on the table.
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I'll say, I'm going to start with you in this position, in that position,
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we might go to that position.
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Where do you want me to touch you? Where can I not touch you?
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But this is also kind of trauma-based stuff as well. So it's really, yeah, carry on, James.
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I would I would argue though that and I think it's
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amazing you do that I'm not surprised you did that at all actually
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knowing you know knowing you but I'd be
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surprised if you didn't do that I think actually more more importantly I'm
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worried that if not everyone is doing that why wouldn't you tell
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someone what you were doing before that you're gonna do it
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because let's face it I think you hit the nail on the head people have
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traumatic experiences you don't know what that person's experience
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in front of you why are you telling them what you're
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about to do you know why can't you inform them and give them
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a choice otherwise it's i mean
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i think about it from a specific i don't take away neurodivergence in
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this but just think about it from an everybody's perspective yeah
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it's almost starts doing something to you you don't know what's about to happen
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and there's a sensation from it well even if
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it's good i mean that could be bad and if it's if it's
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bad that's it could be bad do you know i mean like it
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brings on and giving them the right to consent and the right to understand what
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is happening to their body when you're doing to them that in my opinion is very
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basic you know that that should be the basic you know stuff yeah yeah yeah that's
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insane so I do it with everybody regardless and I you know as I have just started teaching I have started,
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I've only just started but I'm you know drilling it into them and even if somebody is polite.
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I'll always try and this is something like with Matt has experienced as well
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with motivational interviewing it's trying to not ask yes no questions and that
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particularly feeds back into the client feedback loop as well but that that's
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that's I do that with everybody,
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If you get any other stuff you want to put in there, Matt.
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I've listened to you too. It's really nice. It's really context-based.
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I think we're jumping straight in there with some really important points.
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I really like the points. I was thinking in my head, this whole series has had
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this common theme of, yeah, we're talking about how to look after neurodivergent patient or client.
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But ultimately, all of these things are just going to make you a bit of a therapist
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for anybody, whether they're neurodivergent or typical or whatever.
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They're just a human being because you're going to take into account that there
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might be something you're not used to. There might be something different.
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There might have been some way you could better look after them by simply talking to them.
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So it's really nice to hear it. Interestingly, just to end that point,
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my wife says something. So my wife's a researcher within women's health.
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Hence why I'm absolute feminist, absolute humanist, and, you know,
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I hear lots of stuff that I'm really fortunate to hear as a man.
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You know, like, I'm fortunate to hear that stuff.
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But we were talking the other day about cervical smears, and we were talking
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about the fact that some people don't,
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there are certain people that have said, can I do it myself as an insert the,
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I'm sorry, Leslie, I might not, but I don't, it begins with an S, I forgot the name.
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Neculum. yeah and and they've said that can i
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insert that myself and that there
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are actually problems potentially where people don't necessarily want
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that person or want that that that question it's like that's bizarre to me like
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why would you have a problem with someone doing something for themselves because
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that makes them feel comfortable that they're doing something extremely intimate
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and with with sports with with sports like you know soft tissue therapy,
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physiotherapy with so many different clinicians you're doing something that
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is intimate to the body I want you to absolutely have the autonomy about what
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you do or do not do and the understanding before you do it right,
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yeah and I think I think one of the other things that I do as well just from
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other therapists point of view.
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Neurodivergent people can have very busy brains I think everybody would agree
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with that our brains tend to be thinking about a million different things.
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And you can go from a massage thinking that's it i'm gonna
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go i'm gonna go and chill out i'm gonna go and relax we're gonna chill out and
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then you get on the bed or table whatever you want to call it couch and you're
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trying not to think about your lists and all of a sudden the lists come in and
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then so what i started doing um if i can have recognized that i will say i will say.
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How's your brain doing is your brain switching off and I
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will ask everybody this is your brain switching off how are
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you how are you doing and if they say oh I'm
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kind of struggling I'm kind of struggling and I'll say okay do
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you want me to help you a little bit like but ask them permission do
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you want me to help you a little bit and all I
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do is just like for a minute of
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the session or whatever I'll just dip it in and out every so
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often but I just I don't it's it's
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more touching based with their body I don't go into meditation
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mountain I don't go into meditation because I as
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a neurodivergent for me if somebody talks about meditation I want
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to run out of the room um so I talk
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about um relaxing parts of
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the body and I just do it really in my glass region accent
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just go through parts of the body just say just letting
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this bit go let that bit go have a buddha belly let
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your pelvis go i'm speeding up and
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um i've had so many people then say you body doubling me while i'm on the table
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um really helped me to relax into it the funny thing is we we talk about this
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and we talk about this within a neurodivergent kind of field there's a word
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and this word i'm dyslexic, by the way.
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ADHD, I think autism, so AUDHD.
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Discount a few lips.
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I think I'm taking quite a few of the different boxes, which is great.
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I'm actually really happy that I'm neurodiversion. I'm quite proud to be.
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But it does come with its issues.
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There's period perception is is something
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so how we feel right is is
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really important and one of the things that i think is is
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vital is that people feel things in different ways you know like and actually
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or might feel nice to someone in terms of touch might feel really uncomfortable
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for another person you know heavy touch might feel nice for someone so it is
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so independent And it's all about the individual that is in front of me.
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And learning that actually the one-size-fits-all model doesn't fit anyone,
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I think is the best thing anyone can do.
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And actually, it's funny, I'll tell you a story, and sorry to take all the time,
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but I started kind of this side of my professional journey about two and a half, three years ago.
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And I have a really wonderful client.
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Called pat and she's been with me for over a decade now and
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she was chanting with me and has always really looked after me she's
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always believed in me you know and even
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when i didn't leave myself and she she
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sat there in one day she said oh you're doing amazing you're doing great you're
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doing so good and i sat
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there and i went do you want to know the secret and she was like no you
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can't tell me the secret and i was like i'm gonna tell
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you the secret and she said no don't tell me the secret in the
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end i said to her i said john the truth about what i do is asking
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people what they want and then facilitating that that's
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absolute truth right if you put the patient
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or you know your client as the
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absolute number one within the within your work you know what you're doing then
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you will go you'll find it hard to go wrong with that but it's about you know
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it's about challenging when you're bored you know you might have a board of
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work you might have done you know three sessions that in the morning you've
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got one and you're tired and whatever.
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It's about then that you sit and go now i
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need to make this person number one you need to just because ultimately
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you're the one who put those people in the first place that's your responsibility not
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the person lying on the on on on the couch it's about really saying i'm going
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to look after you i'm going to make this for you and i'm going to ask you and
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i'm going to talk to you and i'm a line of communication that works for you.
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That is, in my opinion, the most important thing. Mm-hmm. Mm-hmm.
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Very cool. Great tips. We kind of dipped into the kind of what we can do to
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calm down the senses so there can be better communication.
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I wonder whether you could give us a few more examples for listeners of things
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you can do when that person, even before, even when you're just contacting them
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with an initial email or something,
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is there something you can offer which could make it a little bit more inclusive
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and possibly decide whether that person books in with you or not?
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And then also when they come through the door, if you want them to switch their
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brain off, relax, what could you do with your clinic in order to provide that
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scenario where they are going to be able to relax more?
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Could I take the first one and let's move on to this? Yeah, yeah,
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go for it. I think it would be better than the second one anyway.
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So one of the things that I always teach is the sensory overload in particular.
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There's state one and state two in terms of systems that we kind of generally want run on.
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One is quite high anxiety level. This is all on purpose. It's part of the species survival.
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And the other one is more considerable, more confident.
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You know a really good way of saying this is that i can't
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remember which one is stage one and which one i say to sorry my brain's just
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gone blank because there's time but i do remember
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i think so when you were learning to drive okay you
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were in a state let's let's call it stage one no i think
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it's stage two all right you have to be in there because when you learn to drive
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boys of you that drive well the whole point is that you're thinking all the
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time so you're like oh crap i've got to put the clutch down i've got to do this
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or i've got a signal i've got this so you're constantly aware and have to be
24:51
about what you're doing, the surroundings,
24:53
it's quite a stressful experience, but you need to be in a place that actually
24:58
is a lot lower in terms of energy to do that. Yeah. You can do this like the other.
25:05
State one is the high one. Sorry, I got that wrong.
25:10
So stage two is the common one. Now, once you learn to drive and it becomes
25:15
a bit like walking, you're not really thinking about it because you're completely on autopilot.
25:19
You enter that other stage now the problem with that is that that other stage
25:22
is actually a heightened level,
25:25
Because you have to be heightened. You know, you're driving down the road.
25:27
If you do something wrong, it could kill someone, you know, or injure someone
25:31
or do some pretty horrific things.
25:33
So you're in that autopilot, but that autopilot is really good at keeping you
25:37
out of that, you know, but there is a heightened state.
25:39
Now, you know, if someone's coming to a clinic for the first time,
25:44
they're going to be in a heightened state.
25:46
They don't know what is going on, right? They don't know you.
25:49
They don't know what's going to happen.
25:51
If they've been to 10 other therapists before, they still don't know how you
25:54
were. and there will be differences within that.
25:57
And they're going to have a heightened state. So when we think about that heightened
26:00
state, we know for a fact that any other kind of sensory input to that is going to tip it over the edge.
26:07
So you're already ramped up. It's not going to take you a lot to go over and boil over.
26:12
So the things to watch out for, in my opinion, and to be able to reduce that
26:15
is saying, I'll tell you what, why don't I send a picture of my room,
26:19
my therapy room, right? So they
26:23
know what it looks like when they walk in there, so it's not such a shock.
26:26
Why don't I send a picture of the car park on the road and make sure they've
26:30
got a decent map so that they know that they ought to be stressed out to get in there.
26:35
So getting someone through the door in as little struggle as possible is always
26:41
going to be so, so beneficial to you because for a neurodivergent person especially,
26:46
some of the things, smells, what oil is causing, textures, all of those things,
26:52
right, they're going to impact them.
26:54
And actually, the best thing you can do is make sure that they come in with
26:58
as little kind of anxiety and a heightened state as possible.
27:03
Therefore, you will have the best ability to work with a master there. Yeah, yeah, yeah.
27:08
That's a really nice idea. I mean, yeah, that's really cool.
27:12
Sending them, I like the idea of sending them an image if it's not on your website.
27:16
I mean, just, yeah, getting rid of that shock of arriving somewhere and not
27:21
knowing what to expect. That's really cool. Mm-hmm.
27:25
What else, Lesley? You adapt your clinic in the ways you run things a lot.
27:30
What are you consciously doing or what you discovered works well?
27:33
Well, I mean, I'm quite lucky from that initial people coming to me initially.
27:38
I'm quite lucky because I live in the foot of some lovely rolling hills.
27:43
So people tend, if they're coming to me from somewhere else in Glasgow,
27:48
they tend to start defragging as soon as they sort of start driving out towards
27:53
the Camps of Fells, which is where I am and so and I work on a in a golf club
27:59
and I have my own wee garden outside,
28:02
so the and the car parking's right outside and so my whole kind of setup is is is all very calming,
28:12
immediately anyway when people come but anybody
28:16
that knows me in sort of life knows that I'm actually quite jiggity
28:20
jiggity i'm quite you know i'm quite bouncy and springy so i always say that
28:24
my massage persona is like my alter ego like so when people come in i'm like
28:29
whoa hey james that wasn't you what you were drinking earlier on no i know i
28:34
had i had more than next to me.
28:38
And so so there's something maybe it's the ability of masking i have no idea
28:44
but there's something that when people come in I'm just able to just and I also
28:48
give myself as this is something that I fortunately can afford to do,
28:54
and B I have to do I have to be able to afford to have a half an hour between
29:00
each client or I will get in a flap,
29:03
and if I haven't got a buffer zone of that between each client then I know for
29:09
me as a therapist I'll burn out because I'll get stressed.
29:13
So coming into the room and coming and meeting me in my environment,
29:18
my environment is very low-key.
29:19
I used to be quite clinical in my room, but now it's very low-key, more subdued lighting.
29:25
I've got more natural lighting fitted in it.
29:30
So I keep all that quiet. My music is really low until I establish whether,
29:35
I mean, like really low until I establish whether they are cool with that or not.
29:41
Yeah, I don't use smelly oils unless they ask.
29:47
So, yeah, I try and keep it all really quick and low and neutral.
29:52
I think one of the interesting things you just said there, and I think that
29:55
I don't want to challenge you, Leslie.
29:58
I actually want to halt what you
29:59
said and actually push others to actually work out the way that you do.
30:05
So you take half an hour in between a session because you want to reset yourself,
30:10
give yourself the time to be able to decompress and be able to offer the best
30:15
part, the best service to the next person that comes along. Okay.
30:19
And I would argue that actually you're not doing it for you,
30:22
but you're also doing it for the person that's coming afterwards because they
30:25
deserve the same experience as the person before them.
30:28
One of the things that I experienced years ago, and I worked maybe for 10 years,
30:33
I got about half five in the morning and I'm actually, I come across very, very extroverted.
30:39
I'm actually completely the opposite by nature.
30:43
I'm masked and I'm able to do these things, but they do take a toll.
30:48
Performing, not so much, actually,
30:50
for me. It's more conversations that really, really kind of drain me.
30:54
It is in a conversation that I'm not comfortable with.
30:58
But I remember I used to go to work about 6.30 in the morning as a coach.
31:02
And I used to work through to about 12 o'clock in the afternoon.
31:06
And I would have to go to bed afterwards and i
31:09
had a ripple that i would have to sleep first off it was two well i
31:12
think it was about an hour and a half and i started doing it and there
31:15
was two hours and actually before i stopped doing it it was three hours and
31:20
i felt really bad though i had a lot of guilt about it i had a lot of negative
31:24
self-talk i was really kind of not very trying to myself about it i was lazy
31:28
and you know i kind of beat myself up and you know other people echoed it as a joke.
31:34
And, you know, it wasn't healthy for me, but the actual reality of it is that I, I,
31:41
I couldn't handle that, or I couldn't deal with it. And actually,
31:44
you know, I needed to learn better strategies that would work for me as a professional,
31:50
but also better strategies to keep me healthy.
31:53
But by proxy, and I think it's really, really important, you know,
31:56
what you said, you said, oh, I'm lucky and I'm fortunate.
31:59
And I would say, actually, I don't think you are. I think you're being responsible.
32:03
I think you're being responsible both to yourself and also responsible to the
32:07
people that you work with because you're able to give what is required every
32:11
single time and that service is going to be better and you're probably able
32:14
to retain clients better.
32:17
You won't have as much churn, so most of your clients, therefore,
32:20
marketing, having to market more and all the rest of it because when people
32:23
come to you, they're going to get the same experience from them again,
32:26
which is what they're used to and is what they enjoy and what they need.
32:30
And I think that's really, really important.
32:34
Yeah i suppose it's that old one of look after
32:37
your wellness or you'll have to look after your illness for me
32:40
i can't afford i can't afford burnout so i have to
32:43
do it you know in that in that way the other thing that i do as well i i have
32:48
quite poor recall is one of my things for adhd so i have to really write everything
32:54
in my notes of what position i've had them in what we've talked about what we've
32:57
done because the other thing is people come in and go oh can you do the same
33:00
as you did the last time and I'm like.
33:04
Oh hang on a minute,
33:07
and I'll usually what do you do and the other thing I do at the end because I get quite,
33:13
fall over my words and trip myself up so the thing that I do at the end is I
33:18
ask them to reflect back what if I've been trying to if we've been trying to
33:23
work together with something I'll ask them to reflect back to me how I've explained it,
33:30
in case it's come out like noodle soup and so that they can tell me that I've
33:34
explained it properly to them and then I know.
33:37
Because the other thing is, if I don't think that I've given somebody a really
33:42
good session, I'm beating myself up about that.
33:45
You know, like, I'm overthinking that shit to the max. If I don't think that
33:49
I've given somebody the best service that I can.
33:52
But that's probably quite good at what you do.
33:54
I'm just, well, you've never had a mass sentence.
33:58
Nah, but with everything you said, I've sat there and I've gone,
34:01
you know, when Matt asked the question,
34:02
I want to say the first one because I know Leslie's going to be doing this in
34:08
a way that is appropriate and, you know, maximizing someone's experience because
34:14
you're really saying all those things that you're doing.
34:16
And, you know, one of the really interesting things about being neurodivergent
34:19
is we are so self-deprecating.
34:23
And, you know, you said, I need to do this because I need half an hour before and I'm luxury.
34:28
Mean that actually actually i would argue
34:31
that you're doing it really responsibly and instead
34:35
of being out and say to yourself i'm doing this responsibly you would
34:38
rather take it on as a negative to yourself which which
34:41
we all do and i do countless with every single thing after this i'll come away
34:44
going oh crap what did i say wrong you know what did i say this set someone
34:48
i'm someone's gonna phone in or someone's gonna write in and say this guy's
34:52
like done some you know like We all catastrophize in that way.
34:56
I think it's a real common factor.
34:58
And when you look at the world, how can you not catastrophize?
35:03
Because it's that experience.
35:05
But I would say that actually what you do is quite clearly enough football and
35:09
planned and strategic and all those things. And I think that's awesome. Oh, cool.
35:17
Very cool. Really nicely put, James. If you're doubting yourself,
35:20
send me an email. I'll big you up again. Don't worry. I'll let you know. It's fine.
35:23
Yeah, really nice. Really cool stuff. Somehow it's already 8.50.
35:26
But on the topic of barriers, anything else which either of you have thought
35:30
of which would be useful sharing with our listeners with regards to barriers
35:34
to very urgent patients and clients? I have one.
35:38
I have one. And I actually think it's the most important.
35:42
And I think that the biggest barrier to our community are not,
35:46
in all settings, in my experience, in my opinion, is actually perception.
35:53
I think the general consensus, the general kind of thought about what autism
36:00
is or what ADHD is, is wrong.
36:03
I think that we are perceived in the wrong way.
36:08
Uh and i think
36:11
that that until that changes i think the barriers won't
36:15
truly be removed so i think that well
36:18
i've got two actually there's none of them i've just thought of but sorry but
36:21
i i think the main thing at the moment is to understand what autism is look
36:25
at it it's not rain man don't look at rain man and you know and see the savant
36:30
come it doesn't mean that there aren't savant they're amazing as well they're
36:33
awesome i think they're like incredible,
36:37
you know, but Anthony Hopkins, the actor is, is autistic.
36:40
Alan Shurin, you know, the American Code, potentially, depends on,
36:45
you know, there are different stories coming out.
36:47
There are so many amazing humans, not so many.
36:49
If you look in history, if you go back into history and you look at philosophers,
36:53
you look at scientists, you look at artists, you look at musicians,
36:55
you look at architects, mathematicians, like, I mean, the whole list of it.
37:00
You'll find autism everywhere you look.
37:02
And I would really demand human beings and society to start saying,
37:08
actually, what is autism?
37:09
You know, like being quite... sit there and have a read look
37:12
at something and educate yourself because you know
37:15
i mean by doing that can we actually start moving
37:19
forward and the other thing i would say is go and have a conversation
37:22
with an autistic person you know the misconception that autistic people aren't
37:26
emotionally intelligent well that's not true and really really not true quite
37:33
the opposite go and have a conversation like the people you know that for my
37:37
community and me and people that know,
37:41
they won't judge you for asking questions.
37:44
And that's the amazing thing as well. Like, go and say, look,
37:46
you know, I've heard this, what's the truth? You know, don't feel that you're
37:49
going to be judged by the autistic person.
37:53
Learn to stop judging the autistic person at the same time, is what I would
37:57
say, is go there with an open mind, you know, open eyes.
38:01
And be able to be challenged and be okay to change your opinion as a human being.
38:10
I mean, I would say probably, because, this is double-edged,
38:18
when I see everything, like,
38:21
not the all-seeing eye, what I mean is, if we go out for dinner,
38:25
I can tell you what the person next to us had on for, you know,
38:30
what they were wearing, what that waiter was doing, what was happening over
38:33
there, what was happening, what was there, what was there, and that's really annoying.
38:37
But because i have that when i'm in my treatment room um i'm watching body language all the time,
38:45
and facial expressions which can go against me because then i
38:47
walk away and go oh my god they gave me a funny look like oh they
38:50
think i'm an absolute plonker i would never normally use the word plonker by
38:53
the way um i'm on i'm live and um you know so i watch all the time and quite
39:00
often like people will see though if they're on the table and i'll say something
39:03
they'll go how did you pick that up and it's because i'm literally i'm watching
39:06
the body language all of the time,
39:09
um or any kind of like change of you know facial expressions or anything like that.
39:19
It's a gift that you have and which is why again i'm going to say you're all
39:23
doing what you do i'm gonna have to come all the way up the other end of the
39:26
country this is good this is what what this is stop bigging me up i can't go up.
39:32
That's another thing as well not accepting compliments i'm terrible
39:35
what was the
39:39
i have interest what was the second one you were going to mention james you said
39:42
there was two yeah so i think one one
39:44
really big thing is uh there's a
39:47
lot of guilt from every community and you know
39:50
lots of trauma and everything else one of
39:53
the things i would say for people that are working with the community is
39:56
is and i think this is really really really important is
40:00
you need to do some work to work
40:03
with our community all right plain and
40:06
simple you need to understand how we communicate
40:09
a bit better if you're not part of the community you need
40:12
to understand some of our problems and
40:15
some of the barriers and some of the things that will not
40:19
allow us to to have a positive experience but
40:23
and this is the most important thing if you
40:26
don't want to do that all right i don't
40:30
take it don't say that you're a bad person for not wanting to all right please
40:34
take the guilt away all right i see lots of people well-meaning and i really
40:39
mean this they are decent human beings they are very well-meaning and you know
40:44
they're trying to do something because they know it's the right they're what
40:47
they feel it's the right thing to do all right,
40:50
but actually they may not have the energy to do the research they may not have the energy to.
40:55
Look at doing it appropriately and we're in a real kind of quandary with this
41:00
because if you don't put the effort in that is needed what actually ends up
41:05
happening is that you end up giving a subservice to that person all right or
41:10
an uncomfortable experience to that person.
41:13
And actually the reality of that is if you've got someone and then we i'm sure
41:18
someone's already spoken about you know the likelihood of mental health that
41:21
i mean i think it's something like I think six out of ten people that are autistic
41:28
will think about suicide or are contemplating it at some point.
41:33
I think three out of ten will have actually acted on those thoughts, all right?
41:39
These are all around their experience, okay? The experience is really, really key.
41:43
And actually, if you don't have the energy to do what is needed and what is
41:48
appropriate, all right, to remove the barriers, first off, don't beat yourself up.
41:53
Okay that that's okay you might have a hell of a lot going on in your life all
41:58
right you might be a busy person and you've got your own stresses and everything
42:01
you don't have that ability to
42:03
dedicate that to that and i don't judge you for that at all and i don't i don't
42:08
i don't have any malice or anger or negative feeling about the fact that you
42:13
don't have that because why would you don't have it all right and then that's
42:16
common as well most people don't realize that they're actually they're like
42:19
oh i should be doing this anyway do it when you've got the patience do it.
42:24
Do it when you can do it properly because that's the real time story and if
42:29
you don't and you do it when you don't have the space to understand the community properly,
42:33
what you're doing is potentially, if they have a bad experience with you which
42:37
they probably won't tell you in some cases they won't know why at the time and
42:41
it's something that they'll discover later on when they're digesting and looking back,
42:46
but you may have stopped them from accessing services,
42:50
And actually, the real cost of them not being able to access a service might
42:55
be a service that they desperately, desperately need.
42:59
And the impact on that person is gigantic. So don't feel guilty if you don't
43:05
have the space, you know, because most of you might not have the space now.
43:08
Maybe in six months' time you do. Maybe in a year you do. You know,
43:12
maybe you go, actually, this isn't for me.
43:14
But that's okay. I just want to take the guilt away from people,
43:17
you know, and actually make sure that people are doing things for the right
43:20
reasons and the services they're providing are appropriate for the people that are receiving it.
43:27
That's good. Very valid point. Excellent. Right, it's three minutes to nine.
43:33
So we're going to have to wrap things up. I think, hopefully,
43:38
there's a few ideas there on how to reduce some of the barriers which may be
43:42
presented to your clients unknowingly.
43:45
Like we've all said, you're not doing it on purpose. And ultimately,
43:48
just to reiterate, I think what we said last week or the week before,
43:51
the thing about most healthcare providers, I think particularly if you're getting
43:55
hands on somebody, is you do it for pretty altruistic reasons.
43:59
You want to kind of help others.
44:02
So hopefully the kind of suggestions we've made should come
44:05
quite naturally it's just a case that I never thought of that I never thought of maybe
44:08
having dimming lights oh that was one thing I had to say actually just to realize
44:11
it you and your lights yeah I'm sorry I mean it's a bit like all me me me now
44:16
but sort out your lights I mean I've had to work in some clinics where I've
44:20
just told them I'm not working this this room because you've just got one light
44:23
which is like I don't know,
44:26
bright shatter everything in my eyeballs or darkness you
44:30
know have you ever thought of somewhere in the middle and it's just that room
44:34
is just ridiculous and I think the trouble is some people like it
44:37
some people think it's more clinical that white light they think it's
44:39
almost like a dentist where it's shining down at you but I'm
44:42
pretty sure I mean it'd be a great test for most neurodivergent people
44:45
anyone who says please can you dim those lights a little bit or putting it off
44:48
is a good sign but I think for most people you'd be surprised that
44:51
your interpretation of this looks really professional clean and
44:54
white get a dimmer or get some light you
44:57
end up doing down lighting is the one so
45:00
for most of the community they find down lighting is
45:03
better remembering down lighting it's like
45:05
wall mounted stuff so actually they've got like a
45:08
case on the top of it so that it's dispensing downwards and that
45:11
way in terms of sensory that's normally quite positive people no big light no
45:17
big light on not like if you think it looks a bit like a light that kills flies
45:21
well that kind of tells you something it's that kind of color that's what's
45:25
happening to people's minds where there's total lines underneath it and stare
45:28
upwards and then relax you relax.
45:30
But anyway you have to sort of chuck that in but yeah there's hopefully there's lots of things
45:33
you can do there that's been useful for you and as always keep the conversation
45:36
going if you've got any ideas or comments probably the best place is going to
45:39
youtube and just put something in the comments there so people are starting
45:42
to do that now to continue the conversation because it's not the end of this
45:45
conversation now because it's a new episode so use youtube we're going to be back next week,
45:50
just so you know, for the last episode. God, last episode.
45:54
I mean, that's going to be part four, which is going to be, it's entitled The
45:58
Neurodivergent Therapist.
45:59
So it's really going to be, particularly for people who are either identifiers,
46:04
a neurodivergent therapist, if you're either diagnosed or not.
46:07
And it's going to be a chance for you guys to actually come along and listen
46:12
to some great experts in that field, people who look after professionals who are neurodivergent.
46:16
We're going to have Sarah Mihag, who's going to be along, who's a wonderful
46:20
person. I really encourage you to come and listen to her directly and ask questions.
46:24
She's an occupational therapist and neurodivergent accessibility and inclusion
46:27
consultant at Moodlifter.
46:29
Also, Cassandra Clemens is going to be back. And also, Benjamin Mace Crossley
46:33
is going to be back from part one.
46:34
So I do encourage you to come along live for that. And also on that theme,
46:39
if you are a neurodivergent MSK clinician, then do join the Facebook group.
46:43
There's so many great conversations happening in there now.
46:46
It would be lovely to see you there.
46:49
Which means all I need to do now is thank the people who joined us live.
46:53
Thank you much for your questions and sharing.
46:56
If you are listening to this podcast and you have enjoyed the episode,
46:59
then do please do us the pleasure, the show and gratitude of just leaving a rating or review.
47:05
I know it takes a minute, but it makes such a difference not to make us money or anything.
47:09
It's just so that if somebody puts into Google, you're a divergency for therapists,
47:14
and this episode will come up.
47:15
It's as simple as that. Every rating you leave and review, it means that the
47:18
great word of our guests appears higher in Google results,
47:21
which is one great way of kind of trying to break down some of these barriers
47:24
is just helping that dissemination of quality information, which is what we'd
47:28
like to hopefully do with these podcasts.
47:31
So thank you very much again to my guests, James Giohaggen. Thanks,
47:34
mate. Thank you very much. Yes, guys. Thank you for having me.
47:37
Sorry. Hearing me. Hearing is the word. I was hearing. I wasn't listening.
47:41
I was hearing. I really need a wee right now when I'm sitting here.
47:46
And also, thank you, Leslie Campbell, for joining us. Really appreciate both of your time.
47:50
If you are around next Tuesday at, I can't believe you just said it loud.
47:54
Yes, I can believe it. At nine o'clock, no, eight o'clock on YouTube.
47:58
It'd be a pleasure to see you. You can join us live. This is the podcast.
48:01
Otherwise, keep listening. And we will see you very soon in part four.
48:04
Take care of each other. And we'll see you soon. Bye-bye.