Latest / The STA Clinician Podcast / Ep.271 'Neurodivergence in Healthcare - Part 4 of 4: The Neurodivergent Therapist'

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Ep.271 'Neurodivergence in Healthcare - Part 4 of 4: The Neurodivergent Therapist' · The STA Clinician Podcast

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You're listening to the STA Clinician Podcast, connecting clinicians across healthcare.
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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, creativerunchecklive.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 you join us for part four of our Neurodivergence in Healthcare series in
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January 2026, with the goal of providing valuable information to help soft tissue
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therapists work closer and more effectively with neurodivergent patients and clients.
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Tonight, in this episode, entitled The Neurodivergent Therapist,
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we're going to be discussing steps that neurodivergent therapists can take to
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help look after one's own health and energy capacity, including how to structure
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one's day, build in recovery time,
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use energy accounting, and lots more.
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I'm going to be joined by a couple of people who I'm really looking forward to.
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Sarah Mihag, Occupational Therapist and Neurodivergent Accessibility and Inclusion
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Consultant at Moodlifter and Neuroflect UK.
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And also Cassandra Clemens is returning from part one of the series.
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Cassandra is founder of Heal Your Confidence and a level seven specific learning
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differences specialists who helps in particular late identified neurodivergent professionals.
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We were going to have the wonderful Benjamin Mace Crosley of Repose Injury Rehab
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with us also this evening as advertised.
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Unfortunately, Ben's unable to make it. So do check out part one,
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for example, on communication with Benjamin.
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He's a fantastic clinician, third year BSC sports rehabilitator,
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an all-round lovely chap.
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So sorry you can't be with us, Ben, but we are thinking of you.
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Hopefully not too much because we need to get on the show, but you're here with us in our minds.
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Right. I must give a huge thank as well to my two guests Last week in part three,
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which is episode 270 entitled Barriers, I was joined by James Dewa Haggart,
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founder of StrongPath, new inclusive and mental health informed sports coaching,
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website strongpath.org.uk, and also Leslie Campbell, a massage therapist and tutor based in Glasgow,
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Scotland, website lesliecampbellmassage.co.uk.
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It's a hugely informative episode. I always say that must sound like a record
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broken, but it's a wonderful episode available as always on all podcast apps
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and YouTube if you want to watch the video.
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Looking at barriers that neurodivergent patients and clients so often find themselves
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up against when seeking health care, which typically reduce their access to
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effective or suitable care.
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So that's episode 270. Check it out if you haven't already. and
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also finally before i bring my very patient guests up just
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a reminder that if you do identify as a neurodivergent therapist
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whether through formal diagnosis or not you're very
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welcome and encouraged to join our new private facebook group
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neurodivergent msk clinicians which is
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a safe non-judgmental space to share support chat
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or simply listen search it up on facebook and you
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will find us there'll be a link in the show notes as well please
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remember when you request to join this group there are some questions which
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you'll need to fill out when you join right then back to tonight episode 271
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of the sta clinician podcast the neurodivergent therapist with special guests
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sarah meharg and cassandra clemens.
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Good evening sarah meharg and cassandra clemens how are you good evening,
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evening also really excited because you
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did a world exclusive that neuroflect hasn't been mentioned on air it is brand
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brand new so you're the first person to introduce me with the neuroflect part
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of my title so i'm like oh my god i'm sorry if that was wasn't meant to be leaked
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out then this is what happens on the show things are leaked it's oh it's world exclusive.
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Thank you for that i'm so excited wow great thank
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you so much giving us your time really really appreciate it cassandra
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you're with us with part one sarah you haven't been on the show yet so really
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excited thank you very much um i should also before i forget because i do forget
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now my concentration is solely on you too i forget about the wonderful people
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who have joined us here live tonight so just a little shout out to people who
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have already come through the door if you have joined us and you're not used
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to joining us, then I can bring your comments up on the screen.
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For example, Nikki Mansfield, hey Nikki, how you doing, has said,
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oi oi, in typical Mansfield style. Good to see you.
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Cecily Hislott, welcome, says, evening, lovely. Still at my jigsaw.
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Haven't moved all week. Fantastic, Cecily. I'm sure that's exactly what you needed.
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Glenn Murphy is here saying, good evening all. Very nice. Thanks to joining us, Glenn, as always.
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Danny Hall, loads of people coming in. This is going to be a popular episode, I'm sure.
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Sarah Jones as well. Great to see you, Sarah of the
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st school multitasking cooking tea and
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listening of course you are sarah i'm not surprised at
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all i'm not going to generalize or make any comment there j biker
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freak okay i'm not sure who that would be but we love your name already thanks
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for joining us if you want to put your name in here so i know who you are in
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case i'm talking to somebody i do know then feel free to do that or not stay
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under your biker freak pseudonym if that's what you prefer right i'm going to
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turn to my guest thanks so much
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for joining us people live it really makes only do it because it's live,
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we do upload it as a podcast but I love having it live it makes it much more
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impulsive and who knows what's going to happen so let me turn my attention back
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to Sarah and Cassandra for listeners who are not aware of the work you do maybe
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we could take a moment just to maybe Sarah first of all say who you are where
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you are what you do relevant to to this episode.
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So I'm an occupational therapist. We work in a range of settings.
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So people tend to kind of think about us in terms of working on wards,
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helping people be discharged.
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But our work is about helping recognize the strengths, barriers people face
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in doing the activity that's meaningful and important to them.
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So I've been doing that for 25 years. I've
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worked in every setting you could possibly imagine but
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since 2019 I've been self-employed
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at Moodlifter and that's undergone
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various iterations but predominantly focused
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on working one-to-one and
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providing education around how to
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work with our neurodivergent brains how to
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kind of build a life that is working
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for us rather than the one we think we're meant to have and
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then secondly i've just with one of
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your previous guests rosie launched neuroflect which
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is focused much more on training and cpd and reflective questions as professionals
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we can actually ask ourselves to improve accessibility oh fantastic thank you
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so much for that so relevant to tonight and you're based like rosie in Solihull,
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correct? Yeah, correct.
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Okay, good to know where you are in the world. Fantastic. Thanks, Sarah.
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Cassandra, back from part one, but for people who didn't catch on part one,
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could you give us a little resume of who you are and where you are?
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Yeah, of course I can. Really good to hear about what Sarah is doing.
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I'm very excited about that as well.
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I'm not a therapist as such, but I've been working with neurodivergent students
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to start with for many years and now I'm self-employed I've created the business
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Heal Your Confidence and.
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We are a community interest company. And I've done that because during the time
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I was at the university, not knowing then how very complex neurodivergent I
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was myself, I realized two things.
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One was when people felt really listened to, magic happened very quickly and very strongly.
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And, you know, I've learned from people all the time. And the other thing that
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consistently was very clear to me is that most people have a really,
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really hard time to find out what's actually going on with them.
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And in terms of the neurodivergence itself, you know, so there isn't really...
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Mostly, there is no holistic framework to it. You know, we are not usually autistic or ADHD.
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You know, we have different brains. We think differently and individually.
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That is, you know, we could be all kinds of things, but we've never learned how to use our brains.
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So there is a huge impact of accumulated trauma.
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And that's very often the problem with the dysregulation and so on.
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And as long as you don't know that, you don't know what you're working with,
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And people are a bit stuck.
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And even finding out what's going on in the most basic sense is still very difficult
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for a lot of people because there are very long waiting lists.
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Not everybody gets to understand how to go about it.
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It's very expensive if you want to do it by yourself.
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The NHS is not always very quick to give you support and help.
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So that's why I created the business because I really wanted to serve people in a much better way.
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You know and so as you know we do
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a lot of things we do monthly events we do the
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lunchtime event i love talking to people
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because in all this time i found out that these things apply to myself i just
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thought i was a freak and and i've learned a lot about myself i can do things
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now that i never thought i could be doing so while i'm not a therapist i see
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people on a very regular basis and I hear lots of stories.
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Lots of individual stories, lots of stories as a group.
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Yeah, so that's me. That's wonderful. Fantastic. I'm just thinking here,
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you've got Moodlifter, which in itself is just a great name,
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and then Heal Your Confidence.
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I mean, what powerful, lovely names. Really cool. I don't know how long you
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thought about what you're going to call your businesses, but yeah,
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you did well. I like that.
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A reminder to live viewers, we'd love you to ask questions.
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Okay, there's comments already coming in. Just a reminder because of the nature of what
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we're doing tonight talking about this does go into
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public domain so if you're asking a question which you think might be
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personal you don't want somebody to see it you know how small the
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world is and mundos and baluelo they say in spanish the world
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is a handkerchief doesn't sound so good in english but just bear
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that in mind because it might be something you're sharing which
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we're going to create a wonderfully safe place for you now i mean these two
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guests in particular are going to make you feel so relaxed and free to
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say anything but if you do want to say something which you think you'd prefer
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to be anonymous then if you look at the corner of the screen you'll see
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a slido qr tag so you're welcome to scan that
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and that'll take you to slido and what you can do there is type
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in a question or a comment and nobody know who you
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are which might be more fitting if you have a little think before showing it
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so your boss or your colleagues or you know what it's like
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i'm sure already i'm teaching how to suck eggs bear that in mind but we would love
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to hear from you and share experiences and just remember it
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could go public so think before you type think before you
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type right so thank you
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for that cassandra thank you for the introduction jim hannah hannah
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is asking an important question oh in
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that case thank you how do you deal with the fear of asking to be assessed and
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then not being diagnosed that they'll actually say you're just a bit rubbish
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and humaning well actually hannah you're not the only one i've met many many
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people with that problem because the whole assessment is.
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Framework is very flawed. And I see people in all kinds of ways being stopped
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or being misdiagnosed, actually.
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That's what we are here for. You can talk to you.
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So ask Matt. He tells you how you can talk to us and just go ahead and talk to us.
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Don't keep it to yourself. You will be listened to by people who know,
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who are neurodivergent themselves.
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And surely you are not rubbish and you are not saying things
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that are not true it's just the framework that's letting
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you down there can i also add to
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that because i worked as a diagnostic assessor for
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four or five years i met
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very few people that didn't start the process without
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that fear of what if i'm a fraud what if and that fear can hold us back from
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exploring it and it's a really big vulnerable thing to put yourself forwards
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to be diagnosed what I would say from an assessor's perspective,
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is we know how many barriers there are to getting in front of us you have to
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have gone to your GP you have to have filled in forms,
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you have to have rehashed your whole history and unpicked things.
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Most people don't come to us lightly.
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So we know that there is something going on.
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And whilst I can't speak for every service, what I would say is.
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Good assessment hopefully is about sense making and in a way you might be therapeutic
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and there is a risk that someone might say you may not meet the diagnostic criteria but hopefully that,
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doesn't leave you feeling lost it can happen it doesn't always happen it isn't
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usually a sense of you're a bit
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rubbish in the evening it will be uh-huh according to diagnostic criteria,
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there are other explanations for this
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and we sometimes minimize those other explanations we
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go oh they've said it's just trauma or just this there is no such thing as just
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trauma trauma is so powerful so encompassing having said that i will also acknowledge
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that Not everyone has a positive experience of assessment.
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So getting support around you to self-advocate if you don't feel heard,
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if you have felt misunderstood is also really important.
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Yeah, Sarah, that's so true.
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I think that's, I mean, that was one of the things which, thanks Hannah for that question.
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I think apart from all the other things probably we're going to mention tonight,
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like, you know, looking after the day and getting it structured and what you
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can do in clinic and kind of really, the main thing which we've already kind
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of touched on, I guess, is just realize how much support you can have around
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you and put it in place and have it there.
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Because a lot of people will go alone and it might not be the people
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who traditionally you would suspect of being
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support for you like family it can often be for a
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lot of people not the first people you want to go to with these things especially when
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you're filling out forms and stuff like that so but there are people out there
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who you can confide in and you don't have to straight away you can get to know
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them that's why we set up the facebook group for neurodivergent msk clinicians
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and yeah there there's people out there and and you're probably going to need
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them at some point so i think that's really important to guide you and help
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you throughout the process,
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because it doesn't go smoothly doesn't it it's not always it's not a perfect guess what,
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nhs isn't perfect especially although there are free ways of doing it and there's
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information for people who are worried about not having the money to do it then
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there is right to choose and things like that but it's not a perfect system it never is so.
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Yeah cool anything else on the
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subject of support anything which people might not
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know about which they you think they they could look
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into or consider autism central
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has just launched which is an nhs england so it
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is england specific that is
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good at peer support for families
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but so people often rule themselves out from
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that but if we think of the genetic links
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of autism most the people in there
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are going to be autistic so if you
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have if you're suddenly discovering oh maybe I'm neurodivergent
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because I've seen it in my children or my siblings that
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that is run by a team who
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I've worked with quite a lot of them on the national
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autism training program that the
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whole team is pretty much neurodivergent they have a really good understanding
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from a lived experience as well as an academic and a professional experience
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so they're putting on lots of free events at the moment because it's fully funded
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there's also the facebook group.
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Locally there's quite often directories to be
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aware of in your area that may be
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worth tuning into and Cassandra
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I do believe you've got some stuff as well haven't you to signpost people too
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yeah we have got the monthly events the next one is on Thursday so you can get
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all the details for that and that one is on a new divergence and navigating
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relationships so we have got a different theme every month.
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But we also have got the lunchtime event people can come to and just talk to someone.
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You know, someone who just listens because they know what it's like.
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You know, that's a good starting point. And you might find some really good
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people, even in your friendship group, who haven't talked about it themselves.
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You know, just very gently get it out there and get yourself some support.
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But that's really good to know, Sarah.
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I'll be i'll be capturing these kind of of information
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matt that you can write
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it down somewhere do we capture that information yeah yeah
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i'll go through it with the tooth comb and we'll put into links things like
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like sarah's just pointed out we'll make sure yeah everything we say we're going
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to the links there's another organization i'll get you the link for which is
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for your neurodivergent people in general rather than just autistic people like
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the name i think coming to me off the top of my head but I will give you the link.
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It does again a monthly.
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Zoom call but they've also got a brilliant directory of
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neurodivergent therapists if you decide that you do
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want some private confidential support and
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they've got a lot of really good kind of
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screening to make sure that things are
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kind of going to be helpful to
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you i'll pinky that as well that's amazing
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thank you for that inspired by hannah i
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mean this is kind this is great i'd plan something and that's kind of
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turned itself in its head which is brilliant because that's what we should all
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be doing as clinicians and therapists is listening to what the
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people want and then bending all your own ideas backwards
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so i'm interested in this idea of support before we
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go into ways of putting things in place in clinic i've heard
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you for example cassandra talk quite a lot on on
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the idea of self-compassion and that
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can be like a really important thing because it can be a traumatic
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experience all of this and that's something which yeah
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you need to kind of give yourself could you expand on that a little bit that might
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be really useful for some of our listeners well i
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i don't know about you know hannah and people
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who had that experience but generally speaking i would say most neurodivergent
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people had to work very very hard to get where they are and had to push through
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so many barriers and still But most of the time they felt like an outsider.
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You know, because when we were very small, already we didn't really fit in.
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And so we have to mask that a lot, generally speaking.
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And it just makes us feel that there's something wrong with us.
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And that is a very big reason for emotional dysregulation, talking to ourselves
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as if we were our best enemy instead of our best friend, being very negative about ourselves.
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While very often we have got the greatest compassion for everybody else around
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us, you know, but we see ourselves in a very dim light very often.
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And I have found that usually we need other people who have been through this
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and have come out the other end to help us really overcome that because it's a very old pattern.
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I mean, it probably started very, very young. But it's so important.
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We have to become our own best friends. And why shouldn't we?
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It's amazing what we tend to be able to do.
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And with a little bit of self-compassion, And you also start to think very differently
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about so many different things.
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And you also become more critical about people who have been very critical about
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yourself, but usually in a compassionate way.
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You know, we realize that people just didn't know better or were perhaps afraid,
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you know, about their own weirdness and therefore, you know,
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are quite happily critical of other weird people.
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But it's very difficult to do that on your own. So most people that I have known,
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one way or another, have found a group that would help them,
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have friends where they can discuss that, go to events or even go to therapists
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or go to people like me who have what you would call specialist understanding.
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Does that resonate with you, Sarah? Absolutely.
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I think it's one of those things people can intellectually know about,
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but actually embodying it and feeling it is so different.
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Paul Gilbert, who was one of the writers who came up with compassion-focused therapy,
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he defines compassion as the recognition of suffering, but combined with the
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actions to alleviate that suffering.
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And I think sometimes we separate
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those two parts out into different things and one
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of the hardest things to do is we can often see suffering
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in others but being able to
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feel safe enough and regulated enough to recognize those difficulties in ourselves
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can be really difficult it can be really uncomfortable so I think for me I didn't
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realize until my like mid to late 30s that.
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I got through a lot of things by being in a discomfort that I was so used to
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that I kind of took it for granted and didn't notice it, didn't recognize the
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suffering that could come along with it.
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So it's quite a vulnerable act to go, oh, hang on a moment.
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Let's notice this because then once you notice it, you
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can take an action to address it and start addressing
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some of those patterns that might show up for us
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so you know and particularly you
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know anyone who's in the profession that we're in
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we're generally in it because we're interested
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in people we recognize that people are struggling
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or suffering in some way we can
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sometimes go into the mode of wanting to fix which isn't always
23:08
helpful all the actions sometimes might be about
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validation it might be about compensating
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it it might be about just making space for
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it that we so that we don't become like overcome
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by how overwhelming it might feel because we
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sometimes think oh if i open up this box and see what's in this it'll be so
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big it'll overwhelm me i won't be able to function so that making space can
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be an action and i think the things that it's one thing you You know, as a professional,
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we give our clients homework all the time.
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We have to then reflect on ourselves and think about what works for us and how we can.
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Do things in ways that allow us to go, actually, that's really hard.
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I can give myself permission for that to be hard.
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Yeah, absolutely. You're so right. I don't think that anybody can support someone
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else without supporting themselves and asking those hard questions and allowing
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ourselves to feel in a way that we have never allowed ourselves to feel.
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We always have to be strong or we have
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meltdowns we have you know we put
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such such difficult labels such hard labels
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to our emotions very often you know
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but without actually being able to feel that as
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sarah just said you know feeling those hard feelings feeling
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so it's very uncomfortable feeling you also don't really get an understanding
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and awareness of yourself as a person and we we all have the right to feel ourselves
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as our own person and I think that is where the support comes in because that's so difficult.
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You very often meet somebody else I find or a group of people who can share
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that experience, who can hold that experience.
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Or a therapist, you know, somebody who can offer it, you know,
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but it can come in many different ways but And it's very, very hard on your own.
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And one of the things I will say is shame can keep us going on our own because
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shame is designed to make us hide away. We don't want to be rejected.
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We already feel weird enough or odd enough.
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So shame goes, don't share that. Mm-hmm.
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I think, I don't know if this is a compliment or not, but quite a few of my
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clients go, oh, sorry, you've made me feel very normal today.
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And I think it's because I will model being imperfect, model going,
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actually, we don't always have it together. We don't always get it right.
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And I'm not a therapist sitting up here with my status. I'm going to be with you on this journey.
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But also, I'll get it wrong. And that's okay.
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We'll make errors. we'll make mistakes we
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have to just kind of work through it do you
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think it's kind of i suspect i don't think there's a study being done i think
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it'd be wonderful but i think i suspect that health care is very attractive
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for many neurodivergent individuals because there is a certain altruism or this.
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I know a lot of people criticize this idea of super strengths.
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A lot of people go, I haven't got any super strengths. Life's a nightmare for
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me. Stop saying I've got super strengths.
26:31
But there's an affinity towards looking after others and noticing others' emotions
26:35
and being able, which is such an important part of healthcare.
26:38
But it's a double-edged sword, isn't it? Because you've got that ability to
26:41
notice and do and listen maybe more naturally.
26:44
But then you've also got this other side, which is you're less likely to look
26:48
after yourself. And you're going to give everything to that person in front
26:52
of you and take all that energy away and not care for your own mental health. Is that fair to say?
26:56
Do you think probably that is a situation in healthcare and people who are looking after others?
27:02
I think there are studies done on that. And I recognize when I was at the university,
27:07
because we looked after all kinds of different courses, the healthcare courses
27:12
had a very, very high percentage of neurodivergent students.
27:16
And exactly what you're saying, you know, came across. They wanted so badly
27:21
to look after everybody else, but found it very, very hard to look after themselves.
27:25
I think you are drawn to what you're missing yourself.
27:30
Plus, we tend to be very good at observing. We tend to be very good at listening.
27:36
We want to know. A lot of us really want to know. So yes, we are drawn to...
27:42
I have observed that a lot of therapists and a lot of healthcare professionals
27:47
are under I've achieved.
27:49
I don't know, Sarah, you are one of them. So what is your observation?
27:56
I would say there's probably high, same as I always say to comedians,
28:01
I was like, you're not comparing yourself to the average bell curve here because of what you're doing.
28:05
I think there definitely is, I think as well as it being some of the natural
28:09
strengths, I think it also comes from finding things hard.
28:13
If you don't understand where people are coming from, you can get really curious about that and go,
28:18
oh I want to understand people I'm going to do
28:21
it the way I know how which is academically or theoretically or
28:24
through a structure it can come
28:27
from a sense an over a sense of like over
28:30
responsibility that by making
28:33
missteps when you're younger you suddenly kind of go into
28:36
this pattern of going well to manage those
28:40
missteps that's down to me therefore I'm also
28:43
responsible for this person's well-being so I
28:46
think regardless of neurodivergence or not
28:49
I think the attachment styles of health
28:52
professionals are probably that sort
28:55
of way we keep ourselves safe with other
28:58
people with relationships will mean
29:01
that we're more likely to kind of gravitate towards
29:04
these positions and I think it's it
29:08
doesn't happen often enough but
29:12
I feel like when we have clinical supervision when
29:15
we've got mentoring to try and
29:18
foster relation like a relationship with our mentor or a supervisor where we
29:23
can talk about that human relating part and when we didn't feel responsible
29:28
when we do feel guilty that can be really important for making sure that we can stay Well.
29:36
Because if you're kind of running on feeling responsible, feeling guilty,
29:40
that leads to burnout because.
29:43
We will have clients who we're not necessarily going to be able to alleviate
29:49
all their suffering in the way the client wants us to or asks us to.
29:54
And if we're in tune with that person's emotions and we've built our identity
30:00
on being able to help people.
30:04
You know that's so stressful and so
30:07
difficult yeah this
30:10
is so true and and it's particularly i think i
30:13
mean a lot of listeners are soft tissue therapists massage
30:16
therapists and and they've been
30:19
trained a lot of health care has trained trains you
30:21
to be a fixer where you're doing things to people and that
30:25
double burnout because you feel that you're only you
30:28
know helping them when you're doing things to them so you're taking when they
30:31
don't do it when you give them advice they don't do it then that's going to
30:33
cause turmoil in your mind as well and and
30:37
yeah in healthcare we're just not taught the coaching style enough are
30:40
we where you sit back and just be there and and you know walk
30:43
with them as opposed it's all very direct to approach so yeah lots of oh geez
30:48
i'm feeling negative now okay right the next half hour it's just disaster right
30:53
half hour it's imi break time so imi thanks for joining us imi imi says finally
30:57
i'm so proud of me i told you it would happen Emmy Tester, lovely Emmy Tester says,
31:00
sorry, I'm late. Still at work. So glad you have an OT on.
31:05
Emmy's been asking for about two years, two and a half years,
31:07
get an OT on, get an OT on. So Emmy, there you go. And not just an OT, we've got the OT.
31:13
Also is coming through the door, Deb Bothelovoli. So nice to see you,
31:16
Debs. Hope you're well. Thank you much for joining us.
31:19
So yes, in the next half hour, we've talked a lot about the difficulties and
31:25
the need for support and self-compassion.
31:27
I thought maybe now, because we could talk about that for ages and it deserves
31:31
it, but maybe we'll look now at some specific suggestions.
31:35
I mean, again, there's not going to be one size fits all solutions for everybody,
31:39
which I think is worth mentioning, but maybe just some tips through your own
31:42
experience or people you've worked with of how to look after your working day
31:46
with the idea of a clinician and a therapist or whatever, practice physio,
31:49
chiroprosy or whatever.
31:50
So maybe we could look at them. Some of the things which you've found can help
31:54
people if they are neurodivergent therapists to to have less chance of burnout
31:58
what would you who would you like to start,
32:01
I can start on that. I've got so much to say on.
32:09
Again, we need to acknowledge the one size fits all because I always make,
32:15
I did a brilliant piece of work with one of the most neurodivergent,
32:20
inclusive organizations I've ever worked with.
32:22
But to be really helpful, they sent the interview questions out a week in advance
32:27
because they knew lots of autistic people applying.
32:30
I was like oh I've never had to ask for
32:33
a reasonable adjustment around interview before because if
32:36
I get those questions in advance ADHD brain's
32:40
going to do one of two things it's either going to ignore it and stress about
32:44
it for a week because I can't open it and look at it or it's going to hyper
32:49
focus create incredibly detailed over convoluted answers when it comes to the interview.
32:57
Won't go to that information because that's not new or novel.
33:01
So we kind of tend to think of adjustments as a, oh, if you've got this, you need this.
33:07
And it doesn't work like that. It also heavily depends on the environment that
33:13
you're in because what my needs are when I'm working,
33:18
self-employed, delivering one-to-one sessions over video calls is,
33:25
I'd say largely in my control, but I'm probably my own worst boss because I...
33:32
I'm sitting here with a bright light on so that my client can clearly see my face.
33:38
That isn't aligned with my sensory needs at all.
33:41
But I'm in control of my immediate environment. I can change my lighting.
33:46
I can think about how I schedule my appointments so that it works with my concentration style.
33:54
So I need novelty, but I also take a while to transition between different activities.
34:00
So I like to theme and cluster my days that I
34:03
know that on a Tuesday morning the general
34:06
feeling is this and which will
34:09
be kind of one-to-one client work on
34:11
a Friday morning I'll do supervision I'll do
34:15
so I kind of color cluster it into different themes
34:18
and that helps me with the transition I have
34:21
less control over that when I'm
34:24
doing work for the NHS or work
34:27
for other people and the
34:30
assumption can sometimes be that I
34:34
would know what my own needs are and articulate it and I don't know if you find
34:40
this Cassandra but how often do we kind of assume we know what we want or people
34:45
feel like I can't ask for adjustments or I don't really know what would help
34:51
you know such a common theme.
34:55
So I think the recognizing what your concentration style is like and how easy
35:05
you switch between tasks can give you information or,
35:09
working hours that reflect your
35:14
energy can be useful as well that's
35:18
often possible in both scenarios of
35:20
being self-employed or being employed I have
35:25
a lot of assistive tech that helps
35:28
me conversely there's a lot of assistive tech
35:31
that I really don't like but I've seen work
35:34
really well for some of my clients so it's
35:37
about thinking about where what is my challenge so
35:41
for me one of my big challenges
35:44
which I'm sure many people share is organizing
35:48
and prioritizing that after I've spent half an
35:51
hour an hour with someone what bits of that are important
35:54
to document you know how do I select
35:57
it and make the time and not
36:00
and not think it's just going to take me four minutes because a note never takes
36:04
me four minutes so either recognizing that time and accounting for it or my
36:11
use and i use um some lovely ai gdpr compliance health software that.
36:21
Records my sessions and makes a smart note that I'm then
36:24
oh I'm not working from an empty page I
36:27
can tweak it it's also I
36:30
think really important to recognize if your
36:34
workplace is right for you
36:37
I spent a lot of time thinking I
36:40
should work in hospitals and
36:44
then wondering why I was crying in the toilets in
36:47
my lunch break and I was like actually it's really
36:50
like unpredictable environment it's really overstimulating
36:54
I'm not having processing time I'll
36:58
go work in the community and then working in the community I was like oh I've
37:04
got the thinking time but I'm really overstimulated I'm dyspraxic the amount
37:09
of mental effort for me to plan journeys and work out where I'm going was then
37:13
the next layer of challenge that came up for me.
37:18
And then I've worked out a really nice, happy balance of it works well for me to have a,
37:23
some in-person clinics and it
37:26
works really well for me to be online doing video
37:29
calls and that way I can control my
37:32
environment and have that predictability so
37:36
sometimes we've got to think about is the environment
37:39
that we're in really ever going
37:42
to suit us because I can tolerate being
37:46
in a ward environment but in terms
37:48
of me thriving that's not going to work
37:52
and I've talked for a long time on lots of
37:55
random different bits so I will give you guys a chance to chip in because otherwise
38:00
you'll be right now that was great there was so much in there and don't worry
38:06
I've stored it and now we're gonna because I'm in actually in tune I'm telepathetic
38:11
with our listeners and And I know what they're thinking.
38:15
So first of all is, what's the name of the software she uses?
38:17
So what's the name of the software she uses? I use Heidi Health.
38:20
There's about three or four of them out there.
38:22
Some are geared towards certain professions.
38:26
Heidi Health is a... I know osteos, I know physios that use it.
38:31
So that one's really nice.
38:33
I use Dragon speech-to-text software so that...
38:38
I can talk quite quickly and it's very good at picking up on my accent and translating
38:44
what I'm thinking into writing.
38:46
They're the two main ones. That's really cool. And you mentioned it's all GDPR
38:50
and it's all kind of, you're happy with it and obviously you're going to be
38:53
very big on that. So that's good because people are concerned about that.
38:56
That was excellent. That was the first thing which got ticked in my mind.
39:00
The other thing was just, I really liked the
39:03
way you answered this question because even when i was trying
39:06
to phrase what question should i ask i didn't like the idea what tips that's
39:09
horrible what tips it's like what advice well no you can't advise until you've
39:13
listened to somebody and what they need so it's like what word do i use but
39:16
i think you've really explained it nicely because it's the most important thing
39:19
is to look at your own needs and and that might take.
39:24
In my experience, that might take a conversation like we started off talking
39:28
to someone else because you only know what you know, don't you?
39:30
And you might not know that there's an alternative.
39:32
You know, somebody might be working in a hospital and not realize that this
39:36
isn't the only thing they could do, that they could get support and over this.
39:39
So again, it brings us back to having a mentor or talking with other people,
39:44
having a good network of people who could give you ideas of what else you could do, I guess.
39:47
I've just also realized that I'm just creating and it's not quite,
39:53
there's quite a few documents out there that have suggestions for adjustments you can make.
39:59
There's a US website called Ask Jan.
40:01
There's a great dyspraxia document.
40:04
There's a few different autism ones. I've seen a couple of different ADHD ones.
40:10
What I'm currently trying to create,
40:14
because a lot of those make assumptions is
40:18
something that's kind of easier
40:22
to get people to think about the different aspects of what helps
40:25
and it came about from a conversation with
40:28
a colleague where we'd both
40:31
complete we'd both shared our communication styles and
40:35
I'd put a lot of detail about what does or doesn't work for
40:37
me in email communication and video call communication and
40:41
they were like I've never I thought about that
40:45
and from that they started thinking about what do I need before I meet someone
40:50
what do I need during that what do I need in the communication and there's so
40:56
many things we do in our day-to-day life that we don't break down and we don't
41:00
think about where those challenges,
41:03
might lie and.
41:06
Something as simple as I still forget to
41:09
do it but I try and remember that if I'm saying to someone
41:11
if you're going to email me if you want me to do something put
41:15
in bold action and then I'll I might just
41:17
read and miss a lot of information but if I see bold action
41:21
I know also don't put things in highlight
41:24
because my eyes skim over that and it somehow makes it invisible whilst you're
41:28
thinking highlighting it makes it stand out so we can think about what helps
41:33
us like translate what that person needs and just normalize sharing our different
41:39
communication styles and needs.
41:43
Anyway, that was a side tangent you just reminded me of. That's great.
41:46
No, no, I could tell by your face you were thinking, still thinking of something
41:49
you've ended before, so that's fine.
41:51
But it's, yeah, communication, I think that's something which is interesting
41:55
to pick up on maybe because we're going to have listeners out there who work by themselves.
41:59
So we've kind of said get a support system definitely in place if you're a solo clinician.
42:03
But if you are working in a clinic maybe with other therapists and with managers
42:06
maybe, then I guess some guidance on that of how to communicate with colleagues,
42:12
how to communicate with a manager when you are trying to kind of look for reasonable
42:16
adjustments and things like that.
42:18
So maybe Cassandra, you work a lot with kind of late diagnosed or not diagnosed
42:22
neurodivergent professionals.
42:24
Have you found that there's some ideas which individuals can consider on how
42:30
to improve the way they relate with other people in their work environment to
42:33
make their lives easier,
42:35
but without the fear of kind of rustling feathers or
42:38
that dreadful fear of that eye rolling i think that's another thing which i
42:42
think scares a lot of people and it's big now at the moment and unfortunately
42:45
i understand why it's big social media's got its claws into neurodivergence
42:49
and it's all over the place and there's this and that and it's people are eye
42:52
rolling same way as we eye roll at anything which is just thrown down our throats all the time but.
42:58
Yeah what would you say cassandra that ways to communicate with people around
43:02
you to try and help yourself one thing that i had found most useful when i was
43:08
working still with students because officially they could have those adjustments.
43:13
But they were very often not what they needed, like Sarah was saying.
43:18
So they were boxed in. You can have this, you can have that.
43:22
Nevertheless, they would have helped, but there was not much of an understanding.
43:27
So the eye rolling and the like, oh yeah, okay.
43:30
And also sometimes other students thinking, oh, they've got a privilege over
43:35
me. And I've heard that actually also being said.
43:38
I always suggested, give the person you're talking to a carrot.
43:44
You know, why is that helpful to them to do that?
43:49
So rather than coming in and saying, that's what I need,
43:53
which closes people's minds to some extent, it's like, okay,
43:57
what I really would love to do is improve with that or support you with this
44:02
or do something that I know that is needed on the wall, that is needed in the group.
44:08
And in order to do that it would be really really helpful to have and usually
44:14
these kind of conversations have gone an awful lot better for everybody because
44:18
you are not feeling so ashamed,
44:20
other people don't feel like you're treading on their toes or you're asking
44:24
things that nobody else has to ask for you know but also I think very often
44:29
you're talking to people who themselves have a lot of needs and they're shutting
44:33
down because they haven't yet come to that awareness is that they have those needs.
44:37
So you need to break through that somehow.
44:41
And I have also privately always, for myself personally, always found that that
44:46
helps best to do it that way around.
44:49
So because, you know,
44:52
masking as such is just a tool.
44:56
It's something that burns us out if we don't know that we are doing it or that
45:00
we don't know anything about our needs.
45:03
But you also mask very often for very good reasons. People don't need to know
45:08
certain things about you.
45:09
In certain environments, you have to adapt.
45:13
If you are conscious about that, that's working well.
45:16
I always find that the discussion about what people need is a little bit it's a little difficult for,
45:26
everybody concerned because as Sarah said
45:29
how do we know what we need it might
45:32
be different in different environments everybody needs different software for
45:36
different learning assistance for example I never got on with drug at all I
45:43
know that many many of my students one of the things that we found at the university
45:48
and I was there for 15, 17 years,
45:52
people got all of this software and we know from all the research that it's
45:57
hardly used because people get overwhelmed.
46:01
You get all these different things, but nobody's training you really properly over time on it.
46:07
That's one thing. Then it just doesn't fit with people.
46:11
But what fits, if you can't find out what fits, it can change your whole life, doesn't it, Sarah?
46:16
It just changes everything you do, how you see yourself, how you see the world.
46:20
You can contribute in a totally different way. You don't burn yourself out in the same way.
46:26
So helping people, helping the other person to understand themselves and have
46:33
the patience to try things out all the time.
46:37
And that's not happening very much, but that's what we need.
46:40
You know i i feel i'm one
46:43
of those people who very often says no that's not for me you
46:46
know i don't want that that's too much but if
46:49
if i can persist without being pushed sometimes
46:52
it turns out that it works very well for me in the end but if i feel that i'm
46:57
pushed and i'm boxed in that is very difficult for me then to get over those
47:01
hurdles you know it's just a new thing it's a different thing it's something
47:05
more that i have to deal with so yeah listening listening and actually talking about it.
47:12
What might actually be good for me? What are you using?
47:15
How does that work for you? And how are you using it as well?
47:19
That's a big question. Because sometimes people think, if I get that,
47:24
I have to use it for everything. But no.
47:27
Maybe you're just using it for those 10 minutes of your day or even in a week. That really matters.
47:34
Yeah so yeah offer them a
47:37
carrot yeah i really like that idea
47:40
of offer them a carrot i think it's it's a lovely idea there's definitely a slide there
47:43
somewhere for a presentation that's going to be used and you haven't
47:45
patented it or anything have you it's a really nice idea
47:48
and i think it does because you've got
47:51
to talk the talk haven't you if a manager is there and they're being measured
47:54
on productivity and hitting margins and that sort of stuff and they're living
47:58
that and and like you say they've got their own fears and expectations and pressure
48:02
but if you can say i can you know i've just been thinking how i can really help
48:04
meet my targets more and even go over them if you could do this and that's a
48:08
lovely way isn't it of starting a conversation,
48:11
and yeah getting on their page so ever
48:15
offered anyone a carrot i have kind of done every approach under the sun and
48:21
i'm thinking that the decision to disclose is a really personal one it's really
48:28
hard to do often we end up in this hyper independent state of thinking I've just got to do it.
48:35
Alone and there isn't a right or wrong
48:38
to that but it gets to that point for so
48:41
many people where they go do you know what I'm going
48:44
to burn out or I'm burnt out I'm rock bottom because I've
48:47
done it that way I need to do things differently what
48:52
I would say is ask
48:55
in a way that feels right for you but
49:00
what I experienced so many of my clients
49:03
coming to me with is they feel that they need they can only
49:05
go to the manager when they've got all the answers when actually
49:09
given that we're working in kind of that service industry where we're looking
49:16
at people's health quite often our managers are problem solvers so let's go
49:21
to them with a problem Let's go to them with Angry Leak.
49:27
Struggling with x or if struggling feels
49:30
too vulnerable and you're worried about the perception of that
49:34
because I do like to come from those strengths-based focus actually
49:37
going in with I've been doing a lot of work on my
49:40
self-awareness and how my neurodivergent interplay into
49:44
plays and I've worked out the extra
49:47
these extra levels of effort I'm going to in
49:51
this and it's having this impact on me
49:54
can we sit down together and work out a way
49:58
of managing it so there's that approach
50:01
or sometimes as well as the carrot you got to
50:04
go for the stick of there's an equality act out there
50:07
you know we by being
50:10
neurodivergent you it might be hard
50:13
to say I am disabled but the legal definition
50:16
of disability is something that
50:19
lasts more than 12 months that significantly impacts on
50:23
our performance given you're a divergent you're
50:26
not operating in the way the majority of people will do there are going to be
50:31
significant barriers to doing certain things because they're not built for the
50:35
way you think that comes under that definition of disability so sometimes it
50:40
has to be as straightforward as saying I have.
50:45
Disability here and you've got a legal obligation to meet
50:49
it and that isn't always
50:52
my preferred approach there's often other approaches but sometimes
50:55
we're in services where that's the approach that needs to be taken it can also
51:02
just be matter of fact of saying I've I've realized I insert whatever flavor
51:07
of neurodivergence you're identifying with I need I'd like.
51:13
Access to work can fund support equipment assessment
51:17
disabled students allowance can fund the
51:20
i need to fill in
51:23
the form can i put down the work details so that
51:26
and that's the start of the conversation but
51:30
it's so i think
51:34
there are not just
51:37
barriers in terms of stigma and attitude there can
51:40
be barriers in terms of the systems we work in
51:43
that we work in rigid systems which is ironic given
51:46
you know often your divergent people are
51:49
pathologized as thinking in black and white being rigid and
51:53
actually if we look at the systems we're in they go oh no
51:55
we're not flexible we can only do this process in this one way sometimes it's
52:00
more about kind of thinking about well why why do we have to do that process
52:07
in that particular way what about the way we work can actually make this more
52:12
accessible for us make it more accessible for our clients.
52:17
So yeah there's so many different ways of tackling
52:20
it i like the carrot option but i think there's also the collaboration the stick
52:26
there's so many different ways of doing it of course you know really that is
52:32
very important and it's also different for everybody, you know.
52:38
I think the carrot works well if you already have run across difficulties with
52:43
whatever else you have tried.
52:45
But you have to be very clever and careful. And of course, many of us are not
52:48
clever and careful at that point because we are burned out and everything.
52:54
And again, it's really helpful to have other people who have gone through it
53:00
or who know about it, who can support us one way or another.
53:04
You just shouldn't go it alone if you can help it.
53:08
And it has nothing to do with people liking to be by themselves,
53:13
people being used to be by themselves.
53:16
You still can have a couple of friends or just one friend who is helping you
53:20
forward or somebody you can trust.
53:24
And sometimes you have to go through very uncomfortable feelings to find that person.
53:30
Maybe the first people we are trying are not necessarily the right people.
53:35
You know so again it helps so much
53:38
to be to to put ourselves in environment
53:41
where we can just listen to what other people are doing if we can't bring ourselves
53:47
yet to do something ourselves if that makes sense you know so we always say
53:52
in our events if you just want to sit there even with the camera off we just
53:56
want to listen and just just find your feet within that situation,
54:02
that can be so important,
54:04
how should we know what the right thing is for us until we create that awareness.
54:10
Now Sarah has said it so well, how we are ourselves going through all these processes.
54:16
And we are now more aware because we've done it for a certain amount of times.
54:21
But when I was first diagnosed in my 40s, it was with dyslexia and so I'm dyslexic.
54:28
That was probably the least important thing.
54:31
But it didn't tell me anything. I didn't know what was going on.
54:36
The only thing that I knew and could say was that I had a lot of coping mechanisms,
54:41
and the coping mechanisms were starting to strangle me.
54:45
That was my awareness as far as it went.
54:48
And then about 10 years later, I realized I was so attention different,
54:54
what we call ADHD, and I had both of them.
54:57
No wonder that I thought I was bipolar many years of my life.
55:01
And then 10 years later, I realized that I had a lot of autistic traits,
55:07
I mean, that I was dysproxic, I knew for quite a while, but had a lot of autistic
55:12
traits and that totally floored me.
55:14
I went through such a huge grief process. I could not have talked to anybody
55:18
about my needs at that point.
55:21
It took me about two years before I felt comfortable with it and realized that
55:27
awareness now took so much trauma, so much trauma, so much anxiety out of my life.
55:35
Because now I felt I could look
55:36
after myself and I never had that feeling that I could do that before.
55:40
I didn't need to tell anybody anything, but I would just not do certain things anymore.
55:45
Or I would do it differently, you know, and I would see people around me differently.
55:49
But it took me two years before I had that awareness and another four years
55:54
or five years before I could talk about it.
55:57
So if anybody feels like that, you're not alone.
56:02
Just put yourself into the vibration of people who have perhaps a bit more awareness
56:09
and have gone a little longer down the path.
56:12
That's great advice. Yeah, wonderful. And again, it seems to come around again
56:16
to just talking with other people and not being alone.
56:18
Who would have thought that's the secret to life is not being alone,
56:21
which is often, you know, hard to do, but it is out there.
56:26
And it's a little bit of a snowball effect sometimes once you meet someone you
56:29
can connect with and it kind of opens up.
56:31
I think what you said Sarah that's really true and I know that from experience
56:34
is it's kind of like so often it's the case of either doing nothing and just
56:39
burning out and just collapsing or,
56:41
jumping in all barrels and opening a mouth and saying things you
56:44
regret and just looking like the office lunatic or something because you've just
56:46
gone off on one and that's not going to achieve it either and it's
56:49
trying to find isn't it that space between kind of like the two
56:52
posts and then making sensible decisions so it's
56:56
yeah doing something you can't just rely on
56:59
luck divine intervention there might be someone up
57:01
there i don't know i'm not going to say get to that now but you know what it's
57:05
you're going to need some help to to live in that space in between i think rather
57:09
than just hoping something magic happens and there's different definitions of
57:12
insanity isn't it i don't think einstein said it it's a fallacy that but it's
57:15
doing the same thing again and again and thinking you can get a different outcome
57:18
is is not really a good way of living but.
57:22
Amazing well look it's nine o'clock fantastic advice thank you so much sarah
57:26
and cassandra There's so much to think about there and unpin.
57:29
And we could have talked about so much more, but amazing. Thank you.
57:33
And we have just been able to check in the comments there.
57:35
Ha, says Sarah Clark. Let's just read this out because I know Sarah is going to say something great.
57:40
Sarah says, ha, yes, I often say about neurodiversion people being the ones
57:44
who are creative thinkers. It's everyone else who has rigid thinking styles.
57:48
Yeah, we can finish on that. That's positive because it is us against them.
57:52
Let's not forget that, people.
57:55
That's when we've arrived at the hour after the hour now we we just of course
58:00
we're being yeah if that was typed you'd have a forward slash jk after it just
58:03
to make you realize it's sarcasm or something brilliant right wonderful um thank
58:07
you so much people who stuck with this uh being live,
58:10
just to this is part four this is the end of a
58:12
fantastic month it's been amazing so i just want to
58:15
take the opportunity and maybe people listening to
58:18
the podcast you haven't heard all four maybe you joined in tonight and you didn't
58:20
realize so they are all out there and i just want to
58:23
take this opportunity to just once again take you
58:26
through the other parts we've had just briefly to let you know
58:29
bear in mind again because of the audience we've got tonight there is
58:32
the facebook group you know divergent msk clinicians and we'd love to see you
58:35
there and that could be a starting place a stepping stone maybe and to get some
58:39
support and no words to go next but i just wanted to thank briefly starting
58:43
at part one we had let me just get this right i want to do it in order,
58:50
we started off with communication that was wonderful rosie sexton osteopath
58:53
at alton health and performance and cassandra clemens was there in part one
58:56
founder of heal your confidence and benjamin mace crosley of repose injury rehab
58:59
so that was part one in part two we talked about hypermobility.
59:04
And that was with Bonnie Southgate, MSK advisor at SEDS Connective,
59:08
Jess Yannerman, advanced clinical massage therapist at East Therapies,
59:11
and Rosie Sexton came back for more.
59:12
I think Sarah will be having words with Rosie after this, just jumping in.
59:16
Sorry, Rosie. And then in part three, we had Barriers, which was last week.
59:21
That was with James Gio Haggart, founder of Strong Path, neuro-inclusive and
59:24
mental health-informed sports coaching.
59:26
And the wonderful Leslie Campbell is with us, a massage therapist and tutor
59:28
based in Glasgow, Scotland.
59:31
And then part four, which obviously was tonight, I've had the pleasure of spending
59:35
time with Sarah Mihag, occupational therapist and neurodivergent accessibility
59:39
and inclusion consultant at Moodlifter and the,
59:43
recently yesterday launched neuroflect uk
59:47
which will be in the show notes look out for that and also
59:50
cassandra clemens founder of heal your confidence a great
59:54
month hopefully it'll be something which will help a lot of people and
59:57
hopefully it just won't have a shelf life of like that's it we'll move on
1:00:00
now do share this with people if you've come across it even if
1:00:02
it's like 2027 and it's still relevant they do try and share it but
1:00:05
it will be on youtube hopefully until i don't know
1:00:08
whatever happens next but it relies on people who
1:00:11
are listening to it and joining us to share it and get this great information
1:00:13
out there so do show it where you think it might be helpful because that's why
1:00:17
we do it it's all about helping listeners and just sharing the quality information
1:00:21
of our guests so thank you sarah mihawk thank you cassandra clemens for the
1:00:26
finale it was fantastic i hope you've enjoyed yourselves and found that it useful for you as well.
1:00:31
Any closing thoughts from you two i do not want to be the uh the last person
1:00:35
to talk on this episode that'd be ridiculous sarah what are you thinking i feel
1:00:39
like cassandra's probably got some really calm, soothing,
1:00:43
closing for, whilst I'm like, it's nine o'clock, chaos away.
1:00:48
I'll hand over to Cassand.
1:00:54
I don't have any wise words either. It's too late in the evening for that.
1:00:59
Just the summing up. Help yourself.
1:01:03
You know, move forward one way or another by watching this, by telling other
1:01:08
people about it, by going to an event, by talking to anybody else. Just don't sit tight.
1:01:15
Move on one way or another, whether you feel uncomfortable about it or not.
1:01:20
We all have felt uncomfortable, and we all feel uncomfortable quite often,
1:01:24
even now. It's all right.
1:01:29
Sarah was right, wasn't she, Cassandra? Sarah was totally right at what she
1:01:32
said. Yeah, yeah, wonderful. Closing thoughts. Fantastic.
1:01:35
Okay, well, thank you so much, everybody. If you listen to the podcast,
1:01:37
then do, do, do, do please do us a favor of just leaving a rating and a review.
1:01:41
It'll take a couple of minutes on your iphone if if
1:01:44
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1:01:50
us appear higher in google so thank you if you can do that we
1:01:53
will be back in february the focus is going
1:01:56
to be on pain um i've got some amazing guests lined up for you really looking
1:02:00
forward to that there'll be details to be shown on social media but for now
1:02:03
thank you to everybody who's been part of this focus on neurodivergence in healthcare
1:02:07
thanks to everyone who's joined us and listened thanks to all the speakers and
1:02:11
yeah look after yourselves and look after each other we'll see you very soon.