Latest / The STA Clinician Podcast / Ep.268 'Neurodivergence in Healthcare - Part 1 of 4: Communication'

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Ep.268 'Neurodivergence in Healthcare - Part 1 of 4: Communication' · The STA Clinician Podcast

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You're listening to the STA Clinician Podcast, connecting clinicians across healthcare.
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And we're live. Welcome to the newly named STA Clinician Podcast,
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formerly known for the last five years as the Sports Therapy Association Podcast.
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My name is Matt Phillips, CorellorOneShotLive.com and as always,
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this episode is being recorded live on the Sports Therapy Association YouTube
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channel and Facebook page on a Tuesday night at eight o'clock.
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So as advertised across social media, our focus topic for January,
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2026 is neurodivergence in healthcare, which is going going to be a four-part
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series 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 potentially
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monitor and care for your good selves.
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In Heart One tonight, we're going to be looking at the importance of understanding
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the vital role communication can play when working with neurodivergent patients
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and clients, or indeed with a neurodivergent therapist or colleague,
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as you'll probably see later on with anybody,
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could be a family member, could be a son, daughter, anybody.
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So hopefully there'll be something there for everybody. I'm very shortly going
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to be joined by my special guests, Rosie Sexton of Alton Health and Performance,
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an osteopath, host of the Everyday Athlete cast, as well as being a pioneer
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in women's mixed martial arts, the first British woman to ever compete in the UFC.
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I pity the fall who disagrees with her tonight. And then also in the panel,
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we're going to have Cassandra Clements, founder of Heal Your Confidence,
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a level seven specific learning differences specialist who helps in particular
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late identified neurodiversion professionals.
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And finally in the panel, Benjamin Mace Crosley of Repose Injury Rehab,
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a third year BSC sports rehabilitator, as well as celebrated neurodiverse noisemaker.
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Check out We Have Ghosts on Spotify. You'll hate me for that.
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As always, if you're joining us for the live recording, do please feel free
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to ask questions and share experiences in the comments.
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Do bear in mind that episodes are recorded, so your comments will be in the
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public domain on YouTube, Facebook, and podcast platforms.
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And for that reason, if you want to ask something or share some experience,
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we'll mention again later on, there is a QR code which was advertised where you can use Slido.
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To leave a question which can be totally anonymous if you prefer that
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and then i can bring that up on the screen the panel can answer it or discuss it
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and just write on whatever experience you want
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to share really appreciate you seeing so many of you in the house today a great
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chance for you to either sit back and listen and absorb it all or if you do
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wish then leave some comments or just share some thoughts in the comments section
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we'd love to hear from you let's bring up the panel for this first episode part
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one of our focus focus on neurodivergence in health care.
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Hey everybody how are you doing i was
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getting conscious as i'm sure you'll appreciate just rambling on
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and on and hearing my own voice and thinking oh my god shoot me stop talking
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now but you're here and i really appreciate you giving us your time we're having
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a slight chortle won't we last week or a few days ago about the the irony of
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a collection of neurodivergent people trying to work together to prepare an
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episode on neurodivergence.
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The noun is for a group of neurodivergent people. If anyone's ingestions, then... Oh, it's true.
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Keep it clean. You know what? If anyone knows the answer to that,
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I think it would be Cassandra Clemens. Cassandra Clemens, what's a collective
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word? Is it a whoop or a pod?
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Or what have we got for a group of neurodivergent people?
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I think it can be whatever you like it be. Classic answer. Classic Cassandra
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Clemens answer. Whatever you want it to be.
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Lovely. It'd be like a gosling or something like that, like a,
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almost similar to a group of geese.
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That'd be quite nice. Yeah. Yeah, I can see that.
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So that listeners can get used to your voices, because this is going to be a
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podcast, obviously, maybe we could go around the circle and give a brief summary.
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I know that's tricky, but a brief summary of who you are, where you are in the
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country, and what you do. So maybe, Rosie, would you like to start?
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Okay. So I'm Rosie Sexton. I am an osteopath.
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I work in Solihull. I've got my own small clinic. Here I am.
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And I've been an osteopath for 15 years now. Crikey, it sounds like a long time, I'd put it that way.
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My history with neurodivergence is that I've always known that I'm a bit weird.
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I didn't really have a word for that until I think it was 2021 or 22 when I
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started doing a bit of reading around autism in particular and neurodivergence more generally.
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And a few things started to click into place. and I'd
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run into a whole bunch of issues with this
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was sort of post-covid coming out of the back end of the pandemic and
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I hit burnout quite hard and that was where I started looking for some answers
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and that's kind of taken me down down this path and yeah it's been a it's been
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an interesting journey and it's really affected how how I understand myself
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but also how I work with clients and how I treat people.
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So that's something that I am excited to talk about tonight.
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Excellent. That was so succinct. I feel very proud of yourself.
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That was wonderfully done. Amazing. That's great. Thank you for that.
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I really appreciate your time, Rosie.
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Let's move around to Cassandra Clemens. Would you be so kind as to give a little
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summary of who you are and where you are? Yes, I'm in the Southwest.
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I've worked for the past 20 years with New Year Direction students and ATLs
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and decided I would start a company,
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which particularly is interested in supporting adults,
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neurodivergent adults, to really understand their neurodivergence,
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because very often we are labelled, we are put in different drawers and tightly
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sealed, and it's not like that at all.
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But also, if we really understand our neurodivergence and also what that really means,
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because it's very individual and it's also quite complex because we have grown
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up in a difficult world for us.
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The lift experience, as Rosie already said, a lot of us will come across burnout
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and some of us in a very, very strong way.
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I had two very major burnouts.
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And the lovely thing is once we understand ourselves, we can have so much restoration so quickly.
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So I myself, I would say, rather than being a bit weird, I've been completely
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crazy for many of my life,
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totally standing next to myself instead of being myself, until I realized quite
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late that I'm very, very multiple neurodivergent.
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And i have to deal with that every day but
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it's a wonderful thing that nobody i meet
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has to explain much to me because i understand
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what it's all about and that is a big relief you
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know when we just understand each other really i think so that's
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me that all is that okay mark that's amazing thanks so much yeah thank you and
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double thank you for for joining us this evening when you're not actually in
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england you've gone abroad and you so yeah double thank you for the efforts
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you've mate to join us tonight which brings us around to benjamin ben mace crossley how you doing,
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i'm very good thank you yes similar story actually weirdly enough.
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A few major burnouts i used
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to class them as breakdowns or
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glitches in the matrix just when i mean
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the main one was over 2018 to 2019 i was under so much stress and pressure in
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a as an operational manager and implementation manager for a company and just
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way too many plates to spin And then we'd just moved over to a new area.
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So we'd lost our sort of support network, did me and my now wife.
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And then we found ourselves pregnant as well. So it was just a huge,
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massive, just explosion of just a different world.
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And then you just, you almost, it was
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the realization of I was falling
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apart because I'd lost control of
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how I was managing where I was
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going with my life my own expectations and
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similar always being an oddball
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should we say rather creative and
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stuff and a man of a man of my own mind I yeah
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in 2019 after a the big
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blip I went and sought some
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answers and was diagnosed with ADHD it's
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now suspected ASD as well I had
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a strange little incident with
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with a provider which is still ongoing but it's
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looking like everything's going to be turned around if not a second opinion
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with a new provider that's using a more modern approach should I say a less
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conservative approach so yeah there you are and a soft tissue therapist throughout
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that time and then now I'm back at university back at university my first time
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ever at university at 39 years old just doing my final year in injury rehab
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sports injury rehab at Wrexham University.
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There we go fantastic thank you so much and
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again appreciate your time and your honesty and and it's just
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all of you i'll try not to say this too many times but
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it's just so i'm thinking for listeners it must be really really empowering
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to hear such honesty and if you are affected by tonight and you need to chat
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then contact us we can direct you towards suggestions don't give a shout out
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for you cassandra for your wednesdays that's a perfect place to start i would
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say for my own experience,
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Yeah, Wednesday lunchtime meeting for any professional who wants to just start,
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seek some support, be with other weird people.
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However, we only start in two weeks again because I'm still out of the country. Yeah.
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Okay. That's great. I'll only say Cassandra because I've been there myself and yeah, it's lovely.
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It's amazing. It's great for me anyway, but it's definitely somewhere to stay.
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And like all of these things, which should be the case is if you just want to
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go along and sit back and just listen and even just keep the cam off and just,
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you know, it's nice for you to put your cam on just for the other people in
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the room, but it's just a totally relaxed place just to say,
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oh, this could be interesting. This could help.
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So yes, if anything affects you and you've got anything, then do make sure you
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do reach out to somebody.
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If you're really not sure who to reach out to you then contact matt at
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the sta.co.uk or gary as
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well gary benson who's in the house today as well we'll put some links in
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the show notes just make sure if you are affected then don't just
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swallow it up and try and move on just contact somebody with that
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in mind you'll notice that down here tonight because
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of the topic i think that's pointing towards the qr code
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quite magically hope and there is a qr code and i mentioned it
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earlier on if you do want to ask a question or share an experience but
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you're not too keen on your name being in
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the annals of youtube and facebook forever and on
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being and being watched by 2 000 people this month then you can
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you can click on that we're not clicking it you can scan
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that that's the 2026 word you can scan that qr
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code and it will take you to a slido page where you can ask question or just
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leave a comment or just share something anonymously um if that would help you
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in tonight's show otherwise there's also a link in the notes or you if you want
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to say your name up and you're not worried about that then bring it up in the
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comments and it'll come up but bear in mind that if you do that, everyone will see it.
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So just in case it's something sensitive, then just think about it before you
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put it into the comments and feel free to use that Slido.
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For example, just give you an idea then.
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If I bring this over to, let's go along to that then.
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If somebody did use the Slido question, then what would happen would,
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for example, be, if you did use the Slido link, then I would read it at my end.
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And what I could do, I could paste it in here.
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And it would just come up at Anonymous at my end. For example,
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here, we've got an example.
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Anonymous says, loving this show so far. Thank you very much,
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Anonymous person. It's always nice to start off with a tick,
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tick, and then a wish. What are the other episodes happening this month?
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Funny you should ask that, Mr. or Mrs. or whoever it is, Anonymous.
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Today's communication next week is going to be
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on hypermobility which i know a few people he's
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actually in here and jessica's in here as well that's gonna be with bonnie southgate
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founder of movement anatomy essentials.co.uk and also
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msk advisor at seds connective and jessica jannerman advanced clinical massage
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therapist at ease therapies and rosie's coming back as well for more hopefully
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if we don't kind of like overwork her today but i'm sure that would be really
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exciting as well and then the week after on july the 20th we're going to have
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the topics going to Barriers with special guest James Dewar Haggart,
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founder of Strong Path, new inclusive and mental health informed sports coaching.
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And then also with James is going to be the wonderful Leslie Campbell,
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superb massage therapist at Leslie Campbell Massage.
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And then finally, in part four, the topic is going to be the Divergent Therapist.
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This is on January the 27th at eight o'clock on YouTube or Facebook with special guest Sarah Mihag.
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That is the pronunciation, isn't it? I've never asked Sarah.
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Is it Mihag? Is that good, Rosie?
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Oh, I'll just put you on the spot. We'll delete that from the podcast.
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With Sarah Mihag, I'll just delete, which is not good.
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Occupational therapist, a neurodivergent accessibility and inclusion consultant
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at Moodlifter, and also Neuroflect UK with Rosie.
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And also Cassandra Clemens is going to be back in part four with Benjamin Mason-Crosley,
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who are here with us today.
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So, yeah, a whole month. And that's how we're going to be rolling on the STA clinician podcast.
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We'll keep the focus on one topic each month in February. We've already lined
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up some fantastic speakers on the topic of pain, which is an important one.
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With so much, I don't know, it depends where you hang out, but there's a lot
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of debate going at the moment.
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Does pain need the brain? Is it all about nociception? And there's a lot of
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things flying around and papers coming out. So we're going to have some fantastic guests.
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For example, Dr. Rachel Zofniss, who's going to be joining us for one of them.
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We're also going to have, oh, I'm not going to, I'll leave a hook in there.
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It's going to be a fantastic month. So that's in February.
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Right then. Actually, if I can jump in there, actually, that's a really good link in.
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Because I think there are some really interesting differences in when we're
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talking about neurodivergence and how neurodivergent people perceive pain differently.
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Different in a range of different ways and
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also not only
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is the experience different but obviously that then means that they're
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going to communicate about it differently and it
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might come across differently when they're experiencing it
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so I think when we start talking about pain and
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how pain works it's always worth bearing in
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mind that there is a very different pain experiences
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there is no one singular pain experience that applies
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to everyone and I think this is the core of one of the things that I want to
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talk about tonight is that actually when we're talking about communication and
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particularly when we talk about communication about pain which is one of the
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things we do a lot in our line of work that can look often very different when we're working with,
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neurodivergent people and actually being
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aware of some of the ways in which that can be different I
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think makes us better at talking about pain generally with everyone because
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when we talk about neurodivergence we often like to think about particular categories
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of neurodivergence and particular conditions that people might be diagnosed
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with so we've got you know the ADHD is over there and we've got the autistic
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people over there and we might have people with dyspraxia or you know.
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A range of other things. But actually, when we talk about neurodegenerative.
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We all have different ways of interacting with and perceiving the world around us.
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And while some people are reasonably close to something that we might vaguely refer to as normal,
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although normal doesn't actually exist in a meaningful sense,
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but a lot of people have similar kinds of experience, broadly speaking,
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we do have these outliers.
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And in some respects, again, we can put labels on that.
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But actually, I think the concept is much more general than that.
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And when we start thinking about this, the more you dig into it,
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the more you realise that there's probably a lot of stuff going on that we don't
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have good language for at the moment, which again, I think is one of the things
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that we'll come back to maybe later in this session.
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Hell no. Let's do it now. Let's do face-to-face again. That's a great segue.
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Yeah, the topic of pain. Because at the end of the day, healthcare normally
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is about somebody who's got some kind of pain going on. That's why they come see us.
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So could you expand a little bit, Rosie, as you started that off?
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Can you give us some examples, maybe in your own experience or something you've
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heard of where the pain experience is different and it's connected to a neurodivergency?
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Yeah, so there's some interesting research on this. Back in the bad old days,
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people used to assume that autistic people didn't really feel pain in the same
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way that neurotypical people did.
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And actually, a lot of really awful things happened because there was this assumption
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made that they weren't experiencing pain.
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And a lot of that is actually down to how people were communicating pain.
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And even going right up to date now, I hear from a lot of neurodivergent people
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who have been told at some point,
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they've either been disbelieved by a medical professional they've
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had their pain dismissed because they've had somebody say to
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them oh it doesn't really look like you're in pain or you don't you
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know being in pain because they're not communicating it
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necessarily in the way that that health professional is expecting or they're
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not describing symptoms in the way that the health professional is expecting
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and because of that they can often end up with that being dismissed and actually
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some really serious health conditions being missed. And I see this a lot.
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It's a very familiar story amongst neurodivergent people, and maybe some of
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our listeners can identify with that.
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But I think...
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What we now start to understand is that actually, it's not that neurodivergent
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people perceive pain more or less than anyone else.
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It's just that it's different and it can be different in different circumstances as well.
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You know, some people have maybe have less pain in certain situations,
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but more in others, for example.
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And one of the things that I come across when I work with neurodivergent clients,
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And it turns out that I've got a lot of neurodivergent, not through anything
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deliberate that I've done, but I think somehow we sort of find each other.
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But one of the things that I have found is that neurodivergent people often
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will describe their symptoms in a slightly atypical way, or they might not be
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the way that we're used to hearing them described.
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And i think again going back to the thing of it it's very easy for health professionals,
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well that sounds a bit weird and it sort of gets dismissed or you know pushed
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to one side the example that i really like actually is i had a patient he came
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in and he started out by saying,
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Well, it kind of feels like my shoulder blade. It doesn't feel right.
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It sort of feels out of place. I was like, okay, well, that's interesting.
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Where's the pain? And he was going, well, it's not painful exactly,
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but it feels really uncomfortable. And it feels like my shoulder, it's not engaging.
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We had to dig into this quite a lot because the way he was describing it sounded quite unusual.
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And I wasn't quite sure where he was going with that. but we
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did some testing and I had
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a feel of how the muscles were and how things were moving
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and so that and we we explored it a
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little bit and actually over the course of a few sessions we
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started to unpick this and it turned
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out that actually what he had was almost certainly
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a rotator cuff tendon problem but he
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was describing it in such a different way from how we
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might usually hear that that it
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would have been very easy to kind of go it doesn't really sound like you've
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got a problem there but it clearly it was clear to me
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that there was a problem because he was very concerned about this but
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i think the the interesting thing was we had to go and investigate that and
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i had to try and figure out what his language what that meant in a sense i and
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i think This is something that actually we need to do with all our patients,
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but it's just more obvious in some cases than others.
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Because when people talk about pain, when we think about it,
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we all mean slightly different things.
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You know, if I say, oh, my back hurts, that could be one of a whole bunch of
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different, you know, it could be, maybe I was doing deadlifts yesterday and it's a bit aching.
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Or, you know, maybe actually I've pulled something and it's really acutely painful. or.
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Maybe I've got a medical condition and, you know, this is something else.
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So it could be a whole range of things.
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But we use a similar language for this. And sometimes you have to break that
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down and go, well, actually, what does that look like?
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Can we together work on making that more specific? And it's very common.
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One of the things that I notice, and I'll just finish on this point so other people can jump in.
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But one of the things that I notice is that I spend a lot of time talking to
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people about symptoms and about pain but when I start trying to talk about my
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own symptoms and my own pain,
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I am really bad at that and people don't expect me to be bad at it again because
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of what I do and because when I'm talking about other people's emotions I well
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I like to think that I sound like I know what I'm talking about.
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I sound like, you know, people have said that I'm reasonably articulate.
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But as soon as it comes to, I'm trying to describe what this thing is that's
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going on in my body, because I then have to translate something which is quite vague and amorphous,
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into language, verbal language that.
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A bit unfamiliar these two things don't feel like they
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they quite match up and trying
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to make that translation is really difficult and i noticed
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this i was um one of the physiotherapists who
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i work with he was doing a little bit of work on me at one
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point and he was asking me questions and sort of saying well how
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does that feel and i was kind of going well it's not
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really painful it's just it's a bit uncomfortable i suppose but it's
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kind of and he was getting you're really bad at this it's like
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i sometimes talk to patients who aren't good at explaining their
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symptoms but you're really bad you're the worst it was
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like well yeah yeah yeah i know but you're surprised by this i think that's
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one of the things is that it's not about how articulate somebody is or and again
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i know that there are sort of overlaps
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with other conditions and learning difficulties and things like that.
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But it isn't even to do with that necessarily. Sometimes it's just that the
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signals that we're getting are not easily translated into language because our
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experience of it is quite different from other people's.
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And language relies on having that common framework that we all understand.
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And if you don't share enough of that experience, it can be very hard to find
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a common language that makes sense to you both. Thank you.
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So that felt like a lot of ideas that I've kind of just brought and dumped in the middle of the room.
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Oh, that's great. There was lots of nods happening from Cassandra and Ben.
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Ben, you were nodding quite violently and typing stuff away.
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What reflections have you got from that? I've got things. I've got things.
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Okay. So, yeah, I completely agree.
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And in many cases, it's not so much the words being said,
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But the tone words can be spoken in as well that can sort of interfere with
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the communication that's going on.
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And neurodiverse people themselves can be so, you know, things can get so abrupted
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with their inner sort of calculations and turmoil of how they're negotiating
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the conversation if someone comes in at them too hot.
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Or you know or maybe in a tone that
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there's some sort of trauma that's hidden behind because someone spoke
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to me in a similar sort of tone before and then suddenly just
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highlights something and the alarm bells start in and
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then we're in the state of fight and flight and you
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know then hey and then as we know as well from this then
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pain actually starts magnitude and even
25:02
more when we're in these states of fight and flight so it
25:05
is a really interesting subject and especially just
25:08
like even for myself like if I'm talking to someone I could
25:11
just be walking around the house and I'll be having a conversation
25:15
with myself like always always talking to myself sometimes it's verbally as
25:20
well depending how many people's around I don't want to look you know completely
25:23
mental but you know it's behind closed doors but then I could be having like
25:28
a conversation going on my head
25:29
I've got to a certain point of it and I'll just turn to my wife I'm like.
25:33
So the thing in the corner, I think we'll sort that out on a Saturday.
25:38
And then she's just like, right, what's he going on around? She has to take a minute.
25:42
What was going on? Where's he been? Where's he been in the house?
25:46
And she's trying to then juggle back to the half point of the sentence because
25:50
I've just come halfway through the story and expecting her to catch up where
25:55
I am at. But, you know, she's just watching Traitors.
25:59
It's two times you've plugged Traitors now.
26:03
I'm sorry this is a really bad habit of mine do you mind if i just quickly jump yeah yeah yeah,
26:08
there's that just reminds me of a really useful thing
26:11
actually because when we're talking to patients and we may be taking a case
26:14
history or getting them to explain what's been going on this
26:18
is something that i think often neurodivergent people
26:20
will really struggle with is to give you a clear uh
26:24
sort of step-by-step history of where this
26:27
has come from because we tend to have these trends of
26:30
thought where we kind of go oh we're doing this and then we off go
26:33
off down a mad rabbit hole and before you know it
26:35
you're what the thing was that you were doing that
26:38
before you got to the point where you then did this
26:42
thing where you then felt something in that shoulder and there's
26:44
this whole big long yeah yeah yeah before
26:48
you get there and somehow
26:51
i know you know i think
26:54
neurotypical people expect that they can kind of just summarize that was amazing
27:00
it was beautiful just as you came to your main points that was if this is the
27:05
podcast you're missing out there go to youtube now that's very dramatic keep
27:11
going sorry it was very cool.
27:14
Oh god i hope it's behaving it's good okay but yes so so yes you are distracted now um sorry.
27:25
That's all right see this is what happens you then end
27:28
up down another rabbit hole thinking about something completely different but
27:32
i think that's that's part of the problem is that then being able to
27:34
condense that down to because a doctor you know if you
27:37
go and see a gp for example you've got what is it seven
27:40
minutes and you've got to get your story down to something that you can
27:43
get across and you know answer questions
27:47
and all of those things and pick out all the relevant details and
27:50
not the irrelevant ones in that length of time and
27:53
for a lot of us that's really hard because sometimes
27:57
there's so many details and everything feels relevant it's like
28:00
well how do we condense this down to but actually
28:04
when i've talked to you i've got neurodivergent doctor
28:07
friends and they say the same it's like they they
28:11
can do it when they're doing it as a doctor because that's
28:14
what they've been trained in but actually doing it as a patient they
28:17
still struggle with yeah yeah yeah yeah yeah it's what you're exposed to isn't
28:21
it and then if they're doing it as a as a doctor they're learning that sort
28:24
of almost like a script to follow and what they need to tick off and you know
28:29
they can oh actually i've not i've not touched on this it is it's always kind
28:32
of ticking around in the back of the head, isn't it?
28:35
There's another one which I wanted to catch up on then is when we were talking
28:41
about pain, pain within neurodiversity.
28:44
And that is so interesting because, you know, we are,
28:50
people can be hypersensitive, people can be hypersensitive, but you know,
28:54
there's also a huge study, I think it was in 2024, Systematic Review meta-analysis on.
29:04
Interception and how the brain senses the body which i believe anna maria is
29:08
going down this rabbit hole with a phd isn't she so yeah like you know having
29:14
the altered awareness of of,
29:16
of your body and and then not and then trying to negotiate how to explain that
29:22
to somebody you know they's what it's yeah it's it's no surprise that we we're
29:27
highly misunderstood And then especially when we're trying to be so,
29:29
so literal about it and then struggling to actually find the words because it's
29:35
so obscure and so almost like an alien feeling, but such is like manatees in it.
29:41
But like, he's just so unfamiliar. Like if you happen, like these sort of,
29:45
I don't want to say out of body experiences because, you know,
29:48
we don't want to end up going down,
29:50
you know, kind of sort of XB, like not, not floating outside of your body search,
29:55
but just that disconnection of.
29:58
You know, your central nervous system and your conscious and the vessel that
30:03
you are, you know, controlling as such.
30:07
Yeah, it's great. No, really good. I'm interested, Cassandra,
30:11
because obviously you, you're not in the healthcare in the sense that you have
30:14
people with MSK issues coming to see you, but does any of this relate to you
30:19
as somebody who sees an awful lot of neurodivergent professionals,
30:22
particularly late identified,
30:24
this kind of disconnect with not having the same experiences when it comes to
30:28
communicating with other people because they find it difficult to put words
30:31
to their feelings yeah i mean we hear that all the time i run these monthly
30:36
events on thursday night last thursday of the month on various issues and,
30:43
that that disconnect or that being differently
30:46
connected with ourselves is is
30:49
always the big theme and because trauma
30:53
is so often part of our experience
30:57
either because it's accumulated we are different people
31:00
don't understand us we are supposed to fit in when we really don't fit in and
31:06
we have to somehow find a way around it but also because a lot of neurodivergent
31:10
people come from neurodivergent families and very often the parents are not
31:13
aware of the neurodivergent and they're struggling and there's a lot of shame,
31:17
a lot of guilt going on, a lot of it's all the child,
31:21
you know, so all these kind of things going on.
31:24
But what was really interesting when I heard you speak, Rosie, is because I'm,
31:29
One of the big bugbears that I have is the poster in my surgery's office saying,
31:35
you have got 10 minutes and you're not allowed to talk about more than once.
31:39
And that seems to be so ridiculous in the first place for a doctor, right?
31:45
But also, it's like, okay, I just turn around and go out again.
31:49
Because, I mean, what do I do with that, right? And this describing of what
31:57
I feel is such an interesting thing as well.
32:00
Exactly like you said, how do you describe this?
32:03
There are so many layers to that.
32:06
And it's like partly you see, you try to figure out what you know about your body,
32:13
how it feels, the emotions that have to do with that, what other people have
32:18
said, you experienced before, what you're trying to get out of this,
32:23
and you felt differently yesterday than you feel today.
32:26
What does that mean? How do you explain that?
32:29
And usually I get the same reaction. It's like, what on earth are you talking about?
32:34
What is it that actually hurts or not hurts?
32:37
It's like, well, yeah, it hurt me all of last week. It doesn't hurt me now, but it's still there.
32:42
So what on earth is going on? Explain it.
32:46
And it just needs a lot of time.
32:49
You cannot expect anybody who thinks like that in so many different facets and
32:57
feels in so many different facets to tell you in five minutes succinctly the timeline,
33:03
what is going on, where it is, how it feels.
33:07
And also when I explain what it feels like, I usually get stares Because,
33:13
like you said, there must be a kind of breaking down of how we understand language.
33:23
And I think we are using much more of a, I don't know, a...
33:31
A freer way of explaining things, you know?
33:34
And I wonder how people have learned to explain things, which is a normal explanation.
33:42
I mean, how did that happen? Do they feel different?
33:45
Do they, you know, where was I when they learned how to explain something?
33:51
Yeah, no, it's definitely very widespread. And that disconnect is a big problem
33:56
because not only do you feel,
33:59
differently, explain it differently, but actually you also know that you are
34:04
not connected with it. It's very uncomfortable.
34:07
And it's nearly like, well, I'm here for you to give me an idea what's going on here.
34:12
And of course, mostly therapists don't feel that that is what they are here.
34:17
They're here to do whatever needs to be done for this particular thing.
34:22
So it's nearly like a double whammy you know
34:24
when people come along i guess not just the
34:28
the the communication as that's but the expectations as well yeah and i think
34:34
that's i mean so much of what you said sounds familiar there in that i think
34:39
this is something that so many of us and i i hear this from people i speak to
34:44
as well and often this is a prelude to explaining you know how.
34:49
Some health professional dismissed their experience and told them there was
34:54
nothing wrong or the old one, it's all in your head.
34:58
I had a patient recently, she's a neurodivergent,
35:05
and she'd been to see a rheumatologist and the rheumatologist had told her this
35:09
pain that she was getting was all in her head and she was obviously really upset
35:16
by this after waiting so long for that appointment.
35:19
Anyway, I saw her, we did some ultrasound scans. It was very obviously,
35:25
you know, I'm not a rheumatologist, but this was Bond or rheumatoid arthritis.
35:29
So I sent it to a different rheumatologist and he agreed that yes,
35:35
this is Bond or rheumatoid arthritis.
35:37
But something about the way that that communication happened,
35:40
and I have some thoughts as to what that might have been, again,
35:44
having talked to this patient, if you aren't aware of the way that neurodivergent people often present,
35:51
it's the kind of mistake that I'm not going to say is easy to make because I
35:55
think that sounds like I'm using something that I don't think is excusable.
36:00
But I can see how it happens. And I think this is where actually we need all
36:05
health professionals to have a much better understanding of how neurodivergent
36:11
people experience things differently.
36:14
Because, as you say, it's so common, not only to get that sort of look of,
36:21
I don't know what you're going on, but also that complete lack of understanding.
36:26
I don't understand why you're finding this difficult. you know
36:29
that that sort of and
36:33
that can work both ways as well because i've been on both sides
36:36
of that yeah yeah and as
36:40
i say you know i've been on the other on the receiving end of that and
36:44
it's just so you know it's the one
36:46
thing that's guaranteed to absolutely make me feel awful about
36:49
myself yeah you just feel so sort of small and
36:52
dismissed and you know it's like i'm wasting this person's time
36:56
and again I think that is something you know
36:58
there there's a whole heap of medical trauma
37:02
that neurodivergent people experience as as
37:05
standard almost as they go through life and this is something that again I've
37:09
become increasingly aware of and I think you know I've done a lot of unpacking
37:14
of some of that and some of this adds to why I do what I do and you know why
37:19
I think what I do is important.
37:22
Because again, it's not just for the patient.
37:26
Diagnosis because we know that most people out there
37:28
who are neurodivergent do not have a diagnosis and they
37:31
may not even realize that they're neurodivergent
37:35
but they still have health care needs and they may
37:37
still be experiencing pain in fact they're probably more likely to
37:40
be experiencing chronic pain conditions we know statistically speaking and
37:44
these are often the people who will end up being battered
37:48
from one health care professional to another who end
37:50
up being dismissed who end up you know with some
37:54
awful experiences and not knowing where to go
37:56
with them and this is something i've become really
37:59
passionate about and it's again one
38:02
of the reasons that i think podcasts like
38:05
this are important and also i'm happy to see sarah is on later in the in the
38:11
series but i'm doing some work with her on putting some training together for
38:15
health care professionals working with neurodivergent people because i know
38:19
there's some training out there and And I know things like the Oliver McGowan
38:22
training is a great step forward.
38:25
But I don't think it's enough in terms of understanding some of these factors
38:29
and some of the reasons why so many neurodivergent people get really poor outcomes.
38:37
Right, good segue, because I want to get some tips. I mean, believe it or not,
38:41
we've been talking for 45 minutes
38:43
and it's all been very valuable and I really appreciate all of you.
38:46
I mean, it's a great opening episode because it really is such honesty and sharing
38:50
of experience of your own and with clients is brilliant and it'll set the scene
38:53
for the next three episodes.
38:54
But I'm wondering if the next 15 minutes, we could look at some tips as to how
39:00
to make sure what we've described to reduce the chances of it happening.
39:03
And I'm interested whether it's different than how, in theory,
39:05
we should be talking with any patient or client.
39:08
I mean, there is diagnostic overshadowing of so many populations with women,
39:11
with physical disability. And we've had brilliant people. Alistair Beverley
39:14
on the show has highlighted that.
39:16
What are some, have a little think while I'm just finishing off this sentence,
39:19
but what are some kind of top tips for Google rankings of how to make sure you
39:23
don't make the same mistakes that other healthcare professionals who might have
39:26
the best intentions in the world,
39:28
whether they're a GP and they're trying to fit in 10 minutes,
39:30
what are some of the things we could be doing the listener as therapists in
39:33
order to not make these same mistakes?
39:37
Cassandra, what do you think? Go on, let's go first. Sorry, Ben.
39:40
I'm saving you for the finale. You're the finale, mate. Obviously, you're the last act.
39:44
These are the warm-up acts. You're the last act. Yeah, yeah,
39:46
yeah, yeah. yeah go for excited what do you think i mean you've been at the
39:50
receiving end a lot with gps and things what do you wish that therapists could
39:55
do especially easy things which would just make life so much easier.
39:59
Well, I think if it was me, I would really like to be asked how it affects me
40:04
more than anything else.
40:07
How does it affect you? Because everything else isn't that very important.
40:12
I'm actually here. I might have been waiting for an appointment for ages.
40:18
If I make an effort to speak to anybody about anything, there is a good reason.
40:23
You know and and i think we very often come for to into communications with important others.
40:32
In a way that just is it's not contusive to
40:35
how it impacts okay so
40:39
that's a really good question so rather than going how's your knee how's your back how's
40:41
your ankle it's how is this affecting you so more holistic asking
40:45
about how it's affecting you and your environment which isn't something
40:48
we're taught is it unfortunately in traditional kind of
40:51
health care is it that's the god no but it should be the first
40:53
question one of the things that i always is actually
40:57
whoever you're dealing with you're a divergent you're a typical whatever
41:00
actually that's a really important question is how
41:03
does this affect you and i think that is
41:07
you know when i work with students or new graduates this
41:10
is one of the things who says actually what i'm
41:14
interested in how is this affecting your life what is it you want to be
41:16
able to do that you're struggling with or you know what impact
41:20
is this having because again the same condition
41:23
will affect two different people completely differently brilliant go
41:27
on cassandra give me another one quick before we let rosie rosie and
41:30
ben off off their leashes give me another thing because that was
41:33
a perfect you saw how rosie jumped through the screen at that one so give us
41:36
another thing that you wish i mean that's such a great gold solution for a lot
41:42
of people just what else i wish i wish people would actually learn that the
41:47
most important thing is that you are really giving a moment of proper listening.
41:53
And not of immediately jumping in, I want to get this over with,
41:58
the kind of friendliness as well.
42:00
You know, I saw a physiotherapist the other day, and I mean,
42:04
he said my name, then he turned around and walked in front of me all the way
42:10
down a long hallway into his room, and only then did he turn around and keep the door open for me.
42:17
And it felt like I just don't want to be here at all,
42:21
because that is he isn't interested
42:24
what do i what do i say you know i'm supposed
42:27
to sit down on the chair and then i tell him what it's all about
42:30
it it it feels so alien okay
42:34
so now we're looking at just because again i like to he might just be an ass
42:38
but i like to think that potentially he didn't realize the consequences of his
42:42
action so what do you think he should have done again a simple thing which would
42:46
have avoided that kind of sensation feeling that he was just ignoring you and
42:50
treating you like another...
42:51
You have to use that. You have to look at someone.
42:54
You know, I mean, whether you give them your hand or not, it's very personal.
42:57
Some people don't like to do that,
42:59
especially since COVID, you know, people don't want to do that anymore,
43:02
but you have to make somehow a connection with that person, you know,
43:06
maybe say their name a bit more softly rather than just saying,
43:11
you know, our next one, you know.
43:14
Even if it's just that or just a kind of softness, you know,
43:18
a little bit of soft. Yeah, I'm here.
43:20
You have come to me. You've probably waited. You have got a good reason why you are coming to me.
43:26
I'm here, you know, or even something like it's
43:28
been a very long day i'm a bit tired please don't worry
43:31
if i seem a little bit spaced out i want to
43:34
listen to you something that makes a connection perfect
43:37
and we've got to change this idea and this is something which we're we're all
43:41
i think we're all on our boat to do is get rid of this idea of soft skills we've
43:44
got to get rid of that term because it's not they're not soft skills at all
43:47
they're the most important kind of foundation to bottom the pyramid thing they're
43:50
they set everything else up down there brilliant okay right thank you for those
43:54
because i'm just Just brilliant, both of them are exactly,
43:57
okay, who shall I unleash? Ben, let's unleash you. Go for it.
43:59
Yes, okay. So for me, it's don't assume or presume anything.
44:06
Don't well your, if you feel as a clinician that you are explaining something
44:11
well in your own terminology to somebody,
44:14
don't assume because the person in front of you has nodded along that they grasp
44:20
what it is that you are saying.
44:22
A lot of the time neurodivisive people are nodding
44:25
along despite whether they understand you
44:29
or not because they are just because they're just frightened of
44:32
speaking up and they're they're desperately trying to clutch on to the word
44:36
you are saying and trying to interpret it to what that means to them a lot of
44:42
the time idioms jargon talk or just going off of a vibe it doesn't work with,
44:52
neurodiverse people we kind of have our own idioms and our own.
44:58
Nuances between ourselves that are even quite difficult to navigate between
45:04
ourselves as well because, you know, we are always trying to,
45:07
everything that we're doing is from a learned experience.
45:10
And, you know, if we've learned that being in this scenario is going to end
45:15
in a negative way, then our backs and our anxiety is going to be up.
45:19
So maybe not our backs as such, but, you know, we're going to be really,
45:23
really coy and putting ourselves out there, just even visiting a
45:27
room and trying to speak to you about stuff
45:29
like as soon as i'm off this call i'm i'm
45:33
up in you know a glass of wine or something like i go jesus like powering down
45:38
i mean and it took me an hour or so i had i had a shower before attending this
45:42
webinar just to kind of like you know get get something new in me and kind of
45:48
like wake me back up and make me feel like i'm.
45:52
You know i have that plus it's a nice dopamine here it's a bit cold
45:54
water as well isn't it's it kind of just like zoom in
45:58
but yeah for me it's it's don't assume don't presume
46:01
you know go over those those pointers
46:04
with them help them with their goals because
46:07
half the time they're coming there and they they may have an eye they're coming
46:10
to you for your help okay like just like everybody is treat treat treaters are
46:15
like individuals don't assume anything basically there you go in a nutshell
46:19
that's great and again that would apply to everybody wasn't it if you take that
46:22
extra care If you just look after people better,
46:25
then you'll automatically be
46:27
looking after somebody who's neurodivergent because you're just catering.
46:29
You're just asking them how they are and what they need.
46:33
Those are taken away. I mean, there is a said that actually good practice for
46:38
neurodivergent people is just good practice.
46:40
I think a lot of these things apply regardless. Yeah.
46:45
But they might be particularly important to people who have some of these particular
46:51
challenges, for example.
46:53
I think what Ben was saying about actually how many neurodivergent people just
46:58
have this baseline level of anxiety because we're going around in a world where
47:02
we're expected to be able to make our brains work in the way that other people do.
47:09
And a lot of the time, you know, we can kind of fake it for a bit.
47:14
But it's a big effort you know we're trying having to
47:17
put a big effort in to to act normal there's a
47:19
there's a constant routine running in the back of my head going don't act weird
47:23
don't act weird don't act weird and that's that's occupying about you know 50
47:29
of my my power at any given time and you know you when you when you take that
47:35
away i can do amazing things.
47:40
Yeah it'd be it'd be nice to like offer somebody
47:43
a recap of their of the appointment
47:46
they had with the information i know we always kind of do
47:49
anyway well we kind of like offer that you know would you like what exercise
47:52
sent to you with the dosages etc etc and but kind of maybe just even have a
47:57
summary a recap of what it is that you've actually spoken about just sent to
48:01
them as well just so they can go home and while they're trying to negotiate
48:04
it like in their own mind because as Sarah has just said that, you're right.
48:09
Like sometimes your mind is just focusing completely just on –.
48:16
I'm keeping it together. Right. So, and, and trying to look and trying to look
48:20
like a normal human being.
48:21
So am I making that right? Am I making the right eye contact?
48:25
And then you're watching the lips and, and you're, you're almost like you end
48:28
up mimicking how people talk. And I see myself do it.
48:31
I'm kind of just like, I mean, when I was a kid, I, when I was a kid,
48:35
I went to go see a band and I got talking to the band and they were talking
48:38
to me in an American accent.
48:40
And for about a week I was American and it just happened just right there in front of me.
48:45
I just picked it up i was watching them and i
48:47
picked it up and i was like i got i got
48:51
i got a lot i got a lot of rubbish from my friends for
48:53
that one but like it happened in real time while i was speaking to
48:56
them and they would see to me i just i just went into that
48:59
kind of that person with them and i just turned to meridian and he followed
49:03
on for like a week afterwards i just couldn't drop the accent until i eventually
49:06
did but yeah it's we're so sort of caught up with just trying to negotiate the
49:13
living world outside of our own little comfort zones, that all these,
49:19
some information can be missed, or we could be left hanging on a word from something that you've said.
49:24
So as we've always said before, words matter.
49:28
Tongue matters as well, but also words matter. So if, you know,
49:32
don't, and that's what I'm saying with the dragon, keep it really simple to the point.
49:38
Back it up, if anything, with an email, please. That'd be really nice.
49:42
Yeah, that's something which I'm sure we'll be talking about in future episodes. Go on, Rosie, yeah?
49:48
So, building on what Cassandra said, believe people. Always believe people.
49:53
Believe that they're the experts on their experience.
49:57
You may not have figured out what's going on yet, or what they mean by a certain thing.
50:02
But if you trust that there is something real behind it,
50:05
and you're just trying to unpack that together that goes
50:09
a long way and I think just having that good faith that goes
50:12
a long way and people can feel that so that is
50:15
one of my my big ones and the second one is ask people
50:18
ask people what will help don't expect them to know necessarily that
50:22
might be a journey that you have to work out together you know
50:24
what what things you can
50:27
do that will help them to engage better so as Ben
50:30
says it might be putting something in an email it might be
50:33
for some of my patients I'll get them to record something on their phone
50:35
so they've got it to go back to later you know
50:39
it might be I might sometimes they like to
50:42
write it down sometimes they like me to write it down sometimes they like
50:44
me to email it to them as I say it's sort of we figure these things out as we
50:49
go along but I think if you let people know that it's a safe space that they're
50:53
let them know and ask you things that you're not going to you know be impatient
51:00
or you You're not going to get angry with them or anything like that.
51:04
If something's not working for them, they can tell you.
51:07
And I think when people understand that and they start to open up,
51:11
that's when you start to really see real change.
51:15
And I think this is, for me, one of the beauties of actually being a manual
51:19
therapist, a hands-on therapist, is that we have that whole other language to
51:25
communicate with people.
51:26
And I see that as it's not just treatment, it's communication. And, you know, we...
51:33
I always say that verbal language is not my first language.
51:37
You know, I think I am much more kinesthetic than I am verbal.
51:43
Everything I'm communicating verbally, I've had to translate.
51:46
But when I work hands-on with a patient, it's almost like having that direct connection.
51:52
You know, you're directly communicating with their nervous system and you're getting that feedback.
51:56
And you can put that together with the words, with what you're understanding
52:00
from what they're saying. and you get that bigger picture going on.
52:04
And I think being able to integrate those things together, it's a really powerful thing.
52:09
And I think this is one of the ways in which actually, for the people it works
52:14
for, and it doesn't work for everyone, but for neurodivergent people it works
52:17
for, it can be a really powerful thing.
52:20
I also have neurodivergent clients who don't like being touched.
52:23
And again, another thing, and we can do that as well. That's fine.
52:27
But as I say, a lot of this is down to figuring out what's going to work
52:31
for that person and treating people as individuals so
52:34
it's really sort of seeing it as the essence of person-centered care you know
52:39
it's not just like a lip service to it but it's actually seeing that person
52:42
kind of going i'm trying to understand how their nervous system is perceiving
52:47
the world around them and what it's doing and how to interact with that in a way that's helpful.
52:55
That's great. Great summary. Look, it's nine o'clock, guys. I think I get the
52:59
sensation that we've covered an awful lot in there.
53:02
And I think a lot of the topics we've raised are going to be repeated as we
53:05
look at hypermobilities, we look at barriers, as we look at the neurodivision
53:08
therapists, a lot of it's going to be repeated. So we've set a really nice foundation.
53:11
I really like what you said rosie and i think it sums up a lot of it is just,
53:16
the problem is as clinicians from the from day one we're taught to fix people
53:20
and we're taught to put ourselves on a pedestal our identity is we're superior
53:25
in the sense that we've got loads of knowledge and we can help people and fix
53:27
them that's how we that's why we think we get paid,
53:30
but i think for that reason we believe that
53:33
we're already good communicators and the first rule of communication is first
53:36
law of communication is you're not as good a communicator as you think you are
53:39
you'd be amazed and if you just try
53:42
as rosie what i gathered from you saying is if you
53:45
just kind of take more of a back seat and and ask the person
53:47
how they are let them lead the conversation in mi they
53:50
say you're having a dance with the client but they're leading you okay you're
53:54
with them you're taking a walk with them and any analogy you want to use but
53:57
they're kind of they've got the autonomy and then the thing i like is you'll
54:03
find that the outcomes and the good results you get come so much quicker.
54:08
If you shut them off and start telling them what they need too soon,
54:12
you're going to have that patient.
54:14
Not having success for many, many, many sessions, which shouldn't be the answer
54:18
before you start thinking, great, I'll get them in for eight sessions.
54:20
That's not the idea. You're going to get a bad reputation and you're not going to be successful.
54:23
It might feel like you're spending too much time on listening to them,
54:27
but if you do listen to them, you'll get the result. They'll tell you.
54:30
And then if you listen a bit more, they'll tell you how to fix them.
54:33
And you'll have the solution with their month, maybe.
54:35
But if you keep jumping in and trying these solutions again,
54:38
I know what you need. You need to do it this way. You need to do it that way.
54:40
Boom, boom boom boom boom they'll either not come back and and i'm i'm saying
54:44
this as if it's like just to do with neurodivergent clients it's for everybody
54:47
it's just with neurodivergent clients
54:49
if you don't do this you're really going to lose them and i
54:53
think it's it's understanding what you don't understand and realizing that actually
54:57
you know so very much less than you think you need out the way that there's
55:02
nothing wrong with that it's normal isn't it we're taught that way it's totally
55:05
normal we're not born around your life i think until we start thinking about
55:08
it You go through life assuming other people's brains work basically like yours does.
55:12
And, you know, I did this for a while.
55:15
I think it became clear to me maybe a bit earlier because, you know,
55:18
the other people's brains really don't work the way mine does,
55:21
which caused me a lot of problems actually.
55:25
But I think once you start realising that everyone actually sees the world very
55:30
differently, when you start getting curious about that, that's sort of the first step.
55:36
Yeah, definitely. Right. That's amazing. I'm looking forward to listening to that myself.
55:42
To tell you the truth, it's been one of those kind of hours.
55:44
But we do have to wrap it up. I'm sure you guys have got things to do,
55:47
especially Cassandra, who's an hour ahead.
55:49
I believe it's kind of like pushing on 10 o'clock now for you, Cassandra.
55:52
So thank you for staying up for us next Tuesday.
55:55
Before we let you go, just a reminder of what's coming up.
55:58
This has been a great opener and I appreciate all the guests have been on. next Tuesday
56:01
we're going to be still focusing on neurodivergency in
56:04
in healthcare but we're going to be focusing on hypermobility really exciting
56:08
such a hot topic with evidence and all sorts of connections and things and we're
56:12
really pleased to have Bonnie Southgate the founder of Movement to Nasty Essentials
56:16
and also MSK Advice for SES Connective shout out for SES Connective who's going
56:20
to be with us as well as Jessica Jannerman Advanced Clinical Massage Therapist
56:23
at East Therapies and Rosie's going to return as well so it's going to be a really hot topic.
56:28
It's not just about hypermobility. Don't fall down that trap thinking,
56:31
I've got any hypermobile patients because you'd be amazed that all those people
56:35
who are great dancers and martial artists and have party tricks.
56:39
And at the moment, great, happy days, they're famous, but it's what leads on
56:42
from there if you ask the right questions.
56:44
So I do encourage everybody to try and join us for that.
56:47
If you listen to the podcast, I know life's busy, but do try and set an alarm
56:52
or something. Just book it out as a business meeting. Just try.
56:54
I don't know what's on TV at the same time, but just try and put aside eight
56:57
o'clock UK time for an hour and what you pick up from it, promise you,
57:01
well, I can't promise you, but I almost guarantee it that you'll walk away with
57:04
something which will be really useful for your business and for your own lives and everything.
57:08
So do try and join us if you can live, but if you can't, that's fair enough.
57:11
Just make sure that you repay us with a rating and a review so other people get to know about it.
57:16
So that's it. Thanks once again to my wonderful guests, Rosie Sexton.
57:20
Thank you so much for joining us.
57:22
And Cassandra Clemens, thank you so much as well. And to Ben Mace-Crosley,
57:25
thank you very much as well. Really appreciate your time.
57:28
If you have enjoyed it, people, just one reminder. Oh, thank you for everyone
57:30
who joined us live as well. Really appreciate your comments and questions.
57:33
If you have got more comments and questions, you listen to the podcast, leave them on YouTube.
57:36
Go along to the YouTube channel and write it in there. We'll have a look through
57:39
it for next week, and I'll try and pick up on any questions you might have,
57:42
especially if Rosie is back next week. So don't let the conversation stop now.
57:46
And use the Slido as well. It's going to be the same link, I think.
57:49
Use that to ask questions as well.
57:51
Right, that's it. Peace, love. We're out. Thank you very much.
57:55
Take care of yourselves and take care of each other. We'll see you very soon.