A Love Letter to Neurodivergence

Dear Reader,

This is for all the people who identify as neurodivergent; I hope you feel seen and validated reading this. This is for anyone questioning whether neurodivergence might be a part of their experience, I hope this answers some of your questions, or at least leads you in a direction that will. This is also for anyone who loves, is friends with, or works with someone who is neurodivergent. In a sense, this post is really for everyone. If you’re reading this and think you don’t know anyone who is neurodivergent, guess again. Neurodivergence is mostly an invisible experience. There’s a fair chance you’re in community with neurodivergent people and don’t know due to stigma, masking, and the simple fact that it’s often just not that obvious. 

Each person has the fundamental right to be loved and accepted for who they are without needing to change or conform to societal expectations. This is essential for neurodivergent individuals who often face significant mental health challenges largely due to societal pressures and stigma. When people are accepted as their true selves, it fosters a sense of belonging and reduces the isolation that exacerbates these mental health challenges. Supporting neurodivergent people means recognizing their unique strengths and needs and allowing them to navigate the world on their own terms. This contributes to an inclusive society where all people are valued and understood. 

What is Neurodivergence?

Neurodivergence is a term that is increasingly being recognized in mainstream culture. You may have seen this term circulating on TikTok or depicted more frequently in television and film. That’s because more people have identified with this experience in recent years. According to the Centers for Disease Control and Prevention (CDC), roughly 15-20% of the population identifies as neurodivergent, and that percentage is expected to keep increasing as awareness and research continue to expand. But, what does it mean to be neurodivergent?

The word neuro refers to the brain. Its Latin roots mean nerves or nervous system. Neurotypes simply refer to different types of brains. Neurodiversity broadly describes differences in cognitive processes and sensory experiences. Neurotypical is the way that most brains function. Our brains are all wired somewhat differently, so neurodiversity exists regardless of whether you have a neurotypical or neurodivergent brain. Again, you will likely encounter many neurodivergent people in life and never know. All of that is to say that neurodivergence is a term used to describe brains that diverge from the norm. It’s important to understand that there’s no “right” way for your brain to work. Diversity is always worth celebrating.

Neurodivergence is an umbrella term for many different kinds of neurotypes, such as Attention-Deficit/Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), learning disabilities, and more. Synesthesia, Tourette's Syndrome, Dyslexia, Dyscalculia, Dyspraxia, and Obsessive-Compulsive Disorder (OCD), all fall under this umbrella. Anxiety and panic disorders are more frequently considered a form of neurodivergence as well. The neurodivergent umbrella is constantly evolving as it is still a relatively new way of conceptualizing brain differences. 

ADHD and ASD are most typically associated with the term neurodivergent. ADHD is a neurodivergence (disorder) that affects someone's ability to focus and pay attention, sit still, and/or control their impulses. There are 3 types of ADHD, predominantly hyperactive, predominantly inattentive, or both. ADD is an outdated term because the predominantly inattentive type captures it. People with ADHD tend to need a lot of stimulation in their environment.

Autism Spectrum Disorder is a neurodivergence that affects a person’s ability to interact socially and increases sensitivity to senses. Autistic brains take in way more information because they have more neural connections. All brains go through a pruning system in early development where unnecessary connections between neurons are removed. Autistic brains do go through pruning, but not as much as a neurotypical brain. This is why folks with autism often need less stimulation in their environment. This contributes to what is called “autistic burnout.”  Stimming refers to repetitive or self-stimulating behaviors, such as making movements, and sounds, or saying words that people repeat. Stimming might occur at any time but is often used to calm or self-regulate when someone is overwhelmed. Among other behaviors, stimming might look like someone clapping their hands, tapping their feet, or rubbing or picking their skin. Echolalia is common in autism and involves an involuntary repeating of words or phrases.

AuDHD is a combination of both Autism and ADHD. This probably isn’t a term you have heard of unless you participate in neurodivergent communities. This can be confusing because Autism and ADHD may seem like totally different experiences. There is some overlap though. Both ADHD and Autism are interest-driven. Hyperfocus, the tendency to become completely absorbed in a task, is common in both ADHD and ASD. People with ADHD and ASD tend to experience rejection sensitivity (experiencing rejection more intensely than others) and time blindness (difficulty managing and perceiving time). Before the release of the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it was thought that the two conditions could not co-exist. This highlights how this area of understanding is continuously expanding with new research.

Masking is a term used to describe a process by which people may hide their neurodivergent traits and tendencies in attempts to appear normal. Masking can be intentional or an unconscious process learned and adapted over time. This is a term that has been historically used in the Autism community but has been increasingly used for other neurodivergent or mental health experiences. Masking is a strategy that helps people manage social situations, school, and work. It’s a tool people rely on to manage and achieve in those settings, however, it can result in psychological costs. For example, masking can be exhausting and often leads to burnout. It can also be invalidating and cause tension about one’s identity. Some people are high masking, meaning they can conceal their symptoms more, while others are low masking. High support needs and low support needs are also functional labels that are sometimes used within Autism communities. High functioning and low functioning are outdated terms because they are offensive and problematic, and don’t fully capture the complexity of experiences on the spectrum.  

What’s it like being neurodivergent?

There’s nothing wrong with being neurodivergent. Remember, different isn’t bad. It’s okay to have needs that are different from other people’s. Many qualities that neurodivergent people possess turn out to be gifts that can help them excel in their careers and lives, such as heightened empathy and compassion, unique perspectives, advanced problem-solving skills, attention to detail, the ability to hyper-focus, creativity and imagination, and a passion for social justice and fairness. One thing I want to be careful of though, is sounding too much like a cheerleader. For neurodivergent people, the struggles are so real.

Most challenges arise for neurodivergent individuals because the world is structured for neurotypical brains. It’s not just having this neurotype alone that causes dysregulation, but rather, certain environments that send the neurodivergent individual into sensory overload or burnout over time. Being neurodivergent is often traumatic for people. Quite literally, a neurodivergent experience involves some degree of nervous system dysregulation, especially in cases of ADHD, ASD, and sensory processing disorders. 

Nervous system dysregulation is a key component of trauma. Psychologist and founder of Somatic Experiencing, Peter Levine’s definition of trauma is anything “too much, too soon, or too little (i.e. in cases of neglect)” for our nervous system to handle. I appreciate this broad definition of trauma. This helps us understand that trauma is not only about the event itself but how our bodies interpret the experience. Peter Levine also defines trauma as experiencing fear in the face of helplessness. There’s a lot of overlap with how trauma and neurodivergence presents. 

Everybody has a nervous system. The nervous system runs throughout our entire body and has different states. The sympathetic nervous system state is known as the “Fight or Flight” response to a threat. This state also includes other responses such as Freeze, Fawn (to please someone to avoid conflict), and Flop (to become unresponsive and faint). These are all survival responses. They are all primal and adaptive because they can help you survive. The parasympathetic nervous system state, known as the “Rest and Digest” state, is reached when the body is relaxed and can focus on internal processes like digestion. 

Dysregulated is another term you’re probably hearing more of. This happens when the parasympathetic and sympathetic nervous system are out of balance. Psychiatrist Dan Siegel, M.D., introduced the concept of the “Window of Tolerance”. The window of tolerance describes the nervous system at its optimal level of arousal, where people can access their executive functioning skills (thanks to the brain's prefrontal cortex that allows for planning, organizing, and regulating emotions), be present, and respond effectively. It’s characterized by a sense of groundedness, openness, and ability to connect with other people. When you’re out of your window of tolerance, you’re either in a state of hyperarousal or hypoarousal. Hyperarousal looks like hypervigilance, heightened anxiety, and irritability. Hypoarousal is also a stress response but looks like shutdown, numbness, disconnection from reality, and dissociation. In the long run, hypoarousal looks like burnout or depression.

Everyone gets dysregulated. Everyone’s window of tolerance is also a little different, meaning every person has a personal capacity to handle distress and tolerate big emotions and challenging experiences. There is nothing to be cured. Your body is designed to be in these different states, but it is important to be able to move in and out of them. The goal is to be able to stay regulated for longer periods and to be able to move from one dysregulated state back into your window of tolerance without getting stuck. It’s common for people to get stuck in a trauma state, and not even realize it. Trauma can shrink your window of tolerance and make you more reactive to stress. Neurodivergent folks tend to be chronically dysregulated. You can work towards widening your window of tolerance though. When you learn how the nervous system works and about various ways to get your body back into its window of tolerance, you learn how to become less reactive to stress and increase your capacity to experience the full range of your emotions.

Growing up neurodivergent is also a traumatic experience in and of itself. Neurodivergent kids attempt to fit in socially and meet developmental milestones based on standardized criteria. This is where masking comes into play. Many people experience deep shame about their differences and confusion about why they are the way they are. When neurodivergence is overlooked and not diagnosed, kids are often considered shy, weird, unique, and/or misunderstood. Growing up neurodivergent is especially traumatic if you are undiagnosed. Especially because there is not an obvious physical difference, neurodivergent kids tend to internalize beliefs that they are somehow like everyone else, but worse or defective. They will likely feel stupid or not good enough as they struggle to understand and accept themselves. 

What’s next?   

For the most part, people are the experts in their own lives. I hold this sentiment very close to me and it has been a guiding principle in my work as a therapist. Receiving a mental health diagnosis is generally fraught with both pros and cons. It can be especially empowering, however, for neurodivergent people to receive a diagnosis. These labels can help people understand that their brains are not broken, but rather they just work differently. Finding a label can be very comforting.

While aligning with a diagnosis can be very affirming, the process of getting assessed can be challenging as it can be expensive and time-consuming. The mental health world is catching up in the realm of neurodivergence. It may or may not be worth it to pursue an official diagnosis. Even in the mental health field, there’s a lot of stigma and misunderstanding. It’s difficult to identify and diagnose neurodivergence and there’s a long history of misdiagnosis. Historically, girls and people of color were not diagnosed with ADHD or ASD. Things are changing in recent years, but historically all disorders in the DSM were normalized based on middle-class white men. These experiences are deeply personal. No two people with Autism or ADHD are alike. There is a vast range of traits and tendencies that a person may or may not experience. Two people may have the same diagnosis yet experience a different set of symptoms. There are plenty of neurodivergent-friendly providers out there. It’s all about researching and using discernment when pursuing mental health care. There is also validity to self-diagnosis if one has done a lot of research, self-exploration, and sought out the help of a professional like a therapist or other neurodivergent folks with lived experience. If you need accommodations, you have the right to ask for those, whether you have a formal diagnosis or not.

You might be reading this and wondering how you can help the neurodivergent people in your life. Even though our brains are all wired slightly differently, all human brains are wired for connection. This is a basic need that we all have. For connection to occur, we must experience a felt sense of safety. In the 1940s, psychologist Abraham Maslow published the Hierarchy of Needs, a pyramid depicting the order of human needs from the bottom up. Physiological needs are at the lowest level, which includes the most basic things we need to survive, like food, water, clothes, and housing. Next on this hierarchy is safety. Once safety is achieved, love and belonging can occur. Feeling safe entails a sense of security and protection both physically and emotionally. Emotional safety involves knowing you can be yourself and express your thoughts and feelings without fear of judgment, harm, or rejection. Safety allows for relaxation, authenticity, and trust that your vulnerabilities will be respected and supported. Feeling safe in relationships fosters the ability to grow, thrive, and be confident.

As mentioned before, it can feel embarrassing and shameful to be neurodivergent and to talk about it with others. It’s very vulnerable to share about neurodivergent experiences, but it’s also necessary. You can create safety for your loved ones by building a warm, loving, and compassionate environment based on nonjudgment and curiosity. Consistency is important too. Check in regularly, plan around people’s particular needs, establish routines, and talk openly about differences. It signals safety to let your loved ones know that struggling is normal. Sharing and talking about it helps when we feel validated and cared for.

There’s also sometimes space to work through things collaboratively. If it involves your relationship, communicate how you can figure out what works best for each of you and be willing to make accommodations. If it is something they are sharing with you but does not involve you, check in about what the person’s needs are in sharing. A simple rule of thumb in any relationship (neurodivergent or not) is to say something like, “Thank you for sharing. I am here for you and want to support you. I am listening. Would you like me to simply validate and empathize with your experience or are you hoping for problem solving and solutions?” Oftentimes, what we need most of all is to feel heard.

People deserve to be believed about who they are and what they say their experiences are. Even if someone else’s experiences seem confusing to you or you do not think they are neurodivergent, that does not mean that you have a better understanding of who someone is. As I’ve laid out here, these experiences are layered and complex. There is a ton of misunderstanding and misinformation about neurodivergence in the general public. Many people do not have an accurate understanding of neurodiversity, although this is starting to shift with increased awareness and dialogue. Take it upon yourself to do further reading, listen to podcasts, join a support group, or simply ask and allow people to tell you about their experiences. 

So, it’s important to stay open-minded. Above all else, people deserve to be loved and accepted as they are, without pressure to change or fit into a box that was not made for them. This is especially important considering neurodivergent people are at much more risk for depression, anxiety, thinking about and dying by suicide, and substance abuse. This goes back to that deep-seated belief that “something is wrong with me.” But, nothing is wrong and nothing needs to be fixed. You can remind yourself and your loved ones that your brain works beautifully and is needed. Whether you’re on your journey of self-discovery as a neurodivergent person or you want to learn more about the neurodivergent people in your life, go slow and be gentle with yourself. It takes a lot of time and effort to change your patterns of thinking, learn how to regulate yourself, and have vulnerable conversations.

With warmth and gratitude, 

Kaitlyn Folkes, M.A.

References: 

CDC Data and Statistics (2024) 

https://www.cdc.gov/adhd/data/index.html

https://www.cdc.gov/autism/data-research/index.html

The Developing Mind Daniel J. Siegel (1999) 

The Myth of Normal by Gabor Matė (2023) 

Unmasking Autism: Discovering the New Faces of Neurodiversity by Devon Price, PhD (2022) 

Waking the Tiger: Healing Trauma by Peter A. Levine, PhD (1997) 

Your Brain’s Not Broken by Tamara Rosier, PhD (2021) 

What Are Your Internal Dialogues Trying to Protect You From?

By Concentric Therapist Intern Mara Hundrieser-Acosta, B.A. (Clinical Mental Health Counselor M.A.)

I know I am not the only one that has internal conversations with different parts of myself. Just going back and forth with what I should have done, said, or even experienced. I recently lost my mother to cancer. When someone asks me “How are you doing? I answer with “ I am doing ok, just taking it one day at a time.” but on the inside, my brain is struggling. The actual answer in my mind is, “ I miss my mom, I wish I could see her.” and then another part of my mind answers “I have to cook dinner, wash clothes, put them away, and so much more to do, I feel so overwhelmed.” and another part says, “People will think you don’t have a handle on your life if you let them know how you truly feel.” So, I end up giving a generic answer and smile. 

The conversation inside my mind keeps going even though on the outside I am smiling and making small talk. Sometimes when we have been through hard times, we develop a strong voice that keeps us “in check.” When we view this through an Internal Family Systems (IFS) lens, it's called a Manager. We all have these internal conversations. No, there is nothing wrong with us; it’s just part of how we take care of ourselves internally. You might wonder what I mean about how we take care of ourselves internally. We all go back and forth with all of our parts to try to navigate our lives through stress, anxiety, depression, painful situations, and trauma. Through IFS we can learn what these parts need in order to feel at peace in our life. 

“IFS guides us to offer deep understanding and credible help to the critic and the innumerable other parts who populate our clients’ inner worlds, some of whom long to transform but are stuck in extreme, destructive roles.” -Schwartz & Sweezy (2020)

What is IFS?

Internal Family Systems (IFS), a model of therapy and an approach to better understand ourselves, was developed by Dr. Richard Schwartz. He has worked on the development of IFS for over 40 years.  Dr. Schwartz holds a Ph.D. in Marriage and Family Therapy and was trained to view and understand people through a systematic lens.  After years of working with families and individuals, Dr. Schwartz noticed how clients would speak about their different inner parts. Just like I shared my internal dialogue about being asked about me in relation to my mother. 

While in session with clients, Dr. Schwartz’s patients would share how they would go back and forth with different parts of themselves.  Dr. Schwartz noticed those parts also operate within a system similar to how a system of family operates. For example, a family system consists of different family members, roles or parts (e.g. parents, children) that interact with each other.  

If we look at humanity or systems with a very wide lens, we notice a system is always in place, starting with our solar system. Dr. Schwartz was able to recognize there is a system that consists of people’s inner parts.  These parts are called Managers, Firefighters, and Exiles. These parts have developed to protect us from harm, trauma, and difficult experiences that have left a wound inside our psyche. They all have a specific role that falls under a three-group system. All of our parts are good, even though they might seem mean or aggressive at times. 

The goal of IFS is to help people become Self-led, which means that their various parts feel loved by the Self and trust the Self’s leadership. IFS therapy has a gentle way to ease the pain of people’s experiences and parts and to help navigate the internal turmoil one often faces throughout life. 

The Roles of Parts: A Three-Group System

In order to understand further this three-group system we need to understand that each group or also called protective parts (Managers, Exiles, and Firefighters) doesn't have just one personality. There are different kinds of Managers; each one has its own role to play, as well as the Exiles and the Firefighters to protect us internally. These three-group systems work with each other and sometimes what feels like against each other in order to keep us safe internally. 

In other words…

One group tends to be highly protective, strategic, and interested in controlling the internal or external environment to keep things safe. In IFS, we call the members of this group Managers. 

A second group contains the most sensitive members of the system. When these parts feel injured or outraged, Managers will banish them for their own protection and the good of the whole system. We call them Exiles. 

A third group tries to stifle, anesthetize, or distract from the feelings of Exiles, reacting powerfully and automatically, without concern for consequences, to their distress as well as to the over-inhibition of Managers. We call these members Firefighters. 

Trauma & Internal Family Systems 

According to Schwartz & Sweezy (2020), internal systems (parts) that are responding to trauma not only divide into these roles, but the protective parts (Managers and Firefighters) also form alliances and get into conflicts with each other and can be very harsh or smothering with the Exile they are trying to protect or ward off. The sadder, more terrified, ashamed, rageful, or sexually charged an Exile is, the more protectors legitimately fear its release and the more extreme they become in their efforts to suppress and constrain them. In turn, the more an exile is suppressed, the more it tries to break out. In this way all three groups become victims of an escalating cycle of internecine* conflict. 

*internecine: destructive to both sides in a conflict.

Example: The more ashamed I feel about a traumatic event that happened to me the more scared the Managers and Firefighters are of me releasing or admitting this shame. So, the Managers and Firefighters will try really hard for me to suppress that shame. Which can mean one can begin to use drugs and alcohol to control that shame, or become very narcissistic in order to push it way down. The Managers and Firefighters believe that if one releases or admits this shame, it (the part) will ultimately fall apart. 

Childhood & Internal Family Systems

The Self can be forceful and protective. Children who have experienced developmental trauma or any abuse of their independence, spontaneity, leadership (or other traits that rely on courage themselves) begin to suppress their courageous side. It takes tremendous courage to go toward terrifying places in the psyche. Many protectors avoid stepping out of their roles because they believe the person would be weak and passive without them. Protectors always have intense fears about allowing clients to open the door to Exiles they locked away years ago in inner dark places. When a client says they are afraid to do something, we know a part in their inner world is speaking. But once the part understands the fearless nature of the Self, its fear (and emotional pain, shame, and rage) surrenders.

IFS Therapy has 4 Goals:

1. To liberate parts from the roles they have been forced into, freeing them to be who they were designed to be.

2. To restore faith in The Self and in Self-Leadership.

3. To re-harmonize the inner system.

4. To encourage the person or client to become increasingly Self-led in their interactions with the world.

So, What Does This All Mean? 

The intention of IFS is for the client to access, experience, and be Self-led, to feel safe, to learn their inner world, and understand how their parts work together or against each other in order to protect them. The more we learn and understand about our parts and what they are trying to tell us; it then becomes easier to identify when they get activated. Understanding who we are, where we have been, and what has hurt us, is what is going to give us the opportunities to heal ourselves. The end goal is to be able to be our own saviors, but to get there we must be willing to surrender and be open to learning. 

Once a person experiences faith in The Self and in Self-leadership, the IFS therapist seeks to help the client develop the Eight C’s. 

The Eight C’s

Curiosity: The client learns to be inquisitive, and have interest rather than be judgmental or fearful. This is where one comes with no agenda, one just wants to learn, know, and understand. There is a sense of feeling at ease and moving forward with wonder. There is a sense of safety that opens the door to vulnerability. 

Calm: After being in a high alert state, where one’s nervous system is often aroused, Self-leadership does the opposite by creating a sense of calm that is both physical and mental. The client is able to accept life on its own terms and there is a sense of resilience and assertiveness. 

Courage: When a client says they are afraid to do something in the inner world, we know a part is speaking. But once the part understands the fearless nature of The Self, its fear (and emotional pain, shame, and rage) surrenders. 

Confidence: The Self validates and comforts its Exiles bringing about an infectious air of confidence, conveying to protector parts that it is safe to relax instead of trying to “let it go and move on” (the typical protector advice that encourages people to abandon and isolate their burdened young parts), injuries can be healed. When Exiles are unburdened, the system becomes less delicate and less reactive, and protective parts are more inclined to trust Self-leadership. 

Connectedness: The Self, in its natural state, experiences the sense of connectedness. Instead of trying really hard to obtain a connection with someone, through trauma bonding.  The Self can now move through the world in harmony. Connectedness links with calm and confidence which altogether links up The Divine. 

The Divine: Through extensive research by Dr. Richard Schwartz this is what he describes as The Divine. “Though they used different words, all the esoteric traditions within the major religions – Buddhism, Hinduism, Christianity, Judaism, Islam – emphasized their same core belief: we are sparks of the eternal flame, manifestations of the absolute ground of being. It turns out that the Divine within – what the Christians call the soul or Christ Consciousness, Buddhists call Buddha Nature, the Hindus Atman, the Taoists Tao, the Sufis the Beloved, the Quakers the Inner Light.” 

Clarity: One can see things more clearly. The distortions are no longer in effect and the extreme beliefs ease as one can see authenticity. Our vision is clear when we see through the eyes of the Self versus when our vision is distorted through the eyes of extreme parts.

Creativity: It’s believed that once the inner turmoil and constant struggle start to quiet down and The Self becomes the leader (aka Self-led), creativity can emerge naturally. This means once the managers start to relax, we can problem-solve with greater ease which becomes second nature. 

Compassion:  Once a client finds some separation or healthy distance from their angry or scared part, they can now see these parts from a compassionate lens.  They can express how sad or sorry they are for those parts and are willing to help them heal. This inherent desire to help their suffering parts signifies and taps into compassion. 

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I hope that after reading all this information there is a part of you that feels compelled to explore IFS. I want to say to “the part” of you that has that interest, that feels like it has been lost, in pain, or any other unresolved feelings; you are important and you deserve to be seen and heard. If you are wondering which part that might be, I am talking to your Self-led part; the part that might be hiding in the shadows for a while. 

We live in a time where we are overworked, overwhelmed, on the go, not getting enough sleep, expecting to be everything and nothing at all, where we have to walk on eggshells, but make a difference. It’s no wonder that our Self-led part feels so overwhelmed and just lost. This is the time when we need to slow down and rebel; which translates to going inside, getting curious about your parts, and reconnecting to who we truly are meant to be.

I know it might sound like a big ask, yet if you go back and read about The Eight C’s and imagine experiencing them, I think it’s all worth the journey of healing. The idea of feeling liberated is what motivates me through the IFS lens. I wish for you and my clients to feel liberated from whatever has been holding you back from being your most authentic self and be connected to your Divine. 

So, next time you have those internal conversations bring awareness to what each part is saying, and ask them what they truly need. They are trying to protect you even if they might sound very harsh or act maladaptively; they just haven’t learned a better way, yet, to communicate with you. Even if you don’t think you have the power within you to heal, to reframe those inner dialogues; you actually do, it’s inside you.

Resources for Consideration

Books: IFS online store | IFS Institute 

Videos: Dr. Richard Schwartz explains Internal Family Systems (IFS) Dr. Richard Schwartz Has A Radical Approach To Healing

Podcast: Multiplicity of the Mind: An Approach To Healing the Inner Self | Dr. Richard Schwartz X Rich Roll

What is EMDR and How It Helps Trauma & Mental Health

By Concentric Counselor and EMDR Trained Therapist Bailey Amis, LPC

The Uber you’re in turns onto the highway and you freeze. Your body feels tense, you notice in your shoulders clench up and a tightness in your chest. Your heart rate picks up and you begin to sweat. You can almost see the car wreck you were in three months ago. It’s like it’s happening all over again, and you can feel the fear from that moment. You continue to brace for impact, but it never comes. You arrive at your destination safely, but it takes hours for the tension and fear to fade. You wonder, will I ever be able to ride comfortably in a car again?

The experience described above is a trauma response. A trigger (being in a car and getting on the highway) is communicating to the body and brain that the person is in danger. The mind thinks it is experiencing the traumatic event in the here-and-now and responds accordingly causing your body to tense up and prepare for impact. These physical reactions trigger the emotions that were felt during the original car wreck. Even though nothing has happened during this car ride the body and brain aren’t getting the message that everything is okay. The brain is stuck in the traumatic experience. This can feel hopeless--but it’s not.

What Is EMDR?

EMDR stands for Eye Movement Desensitization and Reprocessing. Developed in 1989 by Francine Shapiro, is a psychotherapy treatment designed to alleviate distress associated with traumatic memories. EMDR uses bilateral stimulation to access and process traumatic memories and other adverse life experiences. Through this processing, the brain synthesizes the experience and distress levels lower.

Reorganizing your brain’s “filing cabinet”

Imagine the brain’s memory network like a long row of filing cabinets. A typical, non-traumatic, memory gets stored nicely and neatly in the cabinets. We can “pull up” the memory (or file) and our brains and bodies know it is in the past, even if it isn’t a pleasant memory. When we experience trauma, the memory doesn’t get stored quite right. Imagine that rather than being filed nicely, the memory is crumpled up and thrown on top of the cabinet. Instead of our brain having to sift through the past to think about the memory, it is already right there. Anytime there is a trigger, the memory is too easily accessible, and our brain gets confused thinking that we are still experiencing the traumatic event every single time we remember it.

EMDR processing helps the brain learn that the memory is in the past. Once processed, although we may still have an emotional reaction to that memory, our body and brain understand that it was in the past and we don’t have the physical reaction, negative thoughts, or images related to the memory anymore. The memory has now been filed neatly in the file cabinet. The processing greatly reduces or eliminates our responses to triggers, allowing for more freedom of movement through the world without worry of encountering a trigger and having a trauma response.

Limitless Healing Possibilities

A common misconception is that EMDR is only effective for one-time traumatic events. Although it is highly effective for these types of traumas, EMDR’s effectiveness is far reaching and growing often as clinicians innovate new ways to use this treatment. EMDR has been proven effective for one-time traumatic events, complex trauma, eating disorders, anxiety, addictions, chronic pain, panic attacks, phobias, and more.

What to Expect During EMDR Sessions

Every client is different, therefore every EMDR session is going to look a little different, however there are a few key pieces to the process that most EMDR sessions will have.

EMDR is structured as three-pronged, focusing on the past, present, and future. A clinician will take a thorough history of the presenting issue. For a one-time trauma or specific phobia with a direct cause this could take a few minutes, whereas for complex trauma or addictions, this could be a multi-session process. The clinician will ask about how this issue presented in the past and may ask questions such as “When is the first time you remember feeling scared?”. They will then assess how the issue affects the client in the present day. Finally, they will assess how this issue affects the client in the future or what worries the client may have about how this issue may affect them.

The EMDR clinician will implement resourcing at the beginning of treatment and will call back to these skills throughout the process. Resourcing is similar to the idea of “coping skills” and is essentially creating a few safe spaces in the brain for the client to have on hand if they feel overwhelmed. An example is creating a “safe calm place” where the client feels neutral, calm, and comfortable. This is done through guided imagery and bilateral stimulation (BLS).

The clinician will facilitate EMDR processing using bilateral stimulation (BLS). BLS is the bread and butter of EMDR. It is what makes the brain put in the work to heal itself. BLS activates the client’s information processing system and taxes the working memory, allowing new, healthier, associations to form with the trauma memory. There are endless ways to get our brains working using BLS but the most common are following the clinician’s fingers with the eyes, following lights with the eyes, using “buzzers” that rapidly switch from hand to hand, and tapping the hands in a rhythmic motion. As the client shares how the memory affects them and the negative belief associated with the memory, such as “I am not safe”, the clinician will walk them through sets of BLS and will ask them to report what they are noticing.

Experiencing Life Without Triggers

Let’s revisit that car ride-the one that brought up the old memories of your car wreck like it was happening in the here-and-now. Imagine that you attend EMDR sessions and process the memory of the wreck. Your therapist walks you through the memory, helps you identify thoughts, images, and body sensations related to the memory, and uses BLS to facilitate processing. After a few sessions you reflect on how differently you feel when riding in a car. You decide to catch an Uber home from your session. You sit calmly in the car and as the driver turns onto the highway you notice that your body does not tense up, your heart rate remains steady, and no disturbing images come to mind. You can remember that you had a car wreck of course, but you tell yourself you are safe now and you believe that you are safe.

There is so much more to the complex world of EMDR, and every clinician and client will have different needs during the process. Finding a clinician that you feel comfortable and safe with will create space for meaningful and effective EMDR work together.

A MESSAGE FROM CONCENTRIC: We recognize various acts of violence, including gun violence range from one victim to multiple people, occur on a daily basis in certain communities (especially within certain parts of Chicago), and within homes and public places, such as schools and venues. We recognize all of these acts are traumatic and we want nothing more than for help and change to take place on various levels. EMDR is one of the many therapeutic tools and interventions that can help reduce the effects of traumatic responses.

For those who were deeply impacted by the devastating and horrific violence at The Fourth of July parade in Highland Park, Illinois, please know our sympathies and condolences are with you. We understand the impact of trauma and we truly hope all of you are able to obtain support from loved ones, community resources, and mental health providers.

For more information on EMDR therapy, please visit:

https://www.emdria.org/about-emdr-therapy/

https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing

https://www.medicalnewstoday.com/articles/325717

Gentle Embodiment

By Concentric Counselor Emily King, LCPC, NCC

When I notice frustration with frenetic Chicago energy, I often turn my mind towards the mountains. Grounding through imagery has brought me time and time again to the mountains of my childhood. Mount Timpanogos is one of seven major peaks found along Utah’s Wasatch Mountain Range and one of my personal sources of peace.

Years ago, a friend and I began hiking just after midnight to try and reach the summit at sunrise. I‘m reminded of the repetition of those first few hours hiking before daybreak. With time and the quiet repetition of climbing an unfamiliar trail, the mindless chatter of thoughts and anxieties shifted towards personal introspection. Early morning hiking requires a kind of concentration which often feels personally out of reach. I find such comfort within the continuous echo of climbing and breathwork.

The movement allowed me to shift into an individually rare meditative state as I began processing painful dissonance and identity uncertainty. As sunshine began to warm my face and the night became day, a knowing settled into my mind and body. My desire to fully separate from the insular religious culture I had always known and finally accept my queerness was made clear. I can point to those early morning hours as the beginning of my embodiment journey.

The renowned trauma specialist and founder of the Somatic Experiencing (SE) method, Dr. Peter Levine, teaches that embodiment is the joining of one’s cognitive awareness and body-based sensations. The awareness and acceptance that our body is our own. The integration of somatic skills including resourcing, pendulation, and titration can encourage embodiment through gentle reminders that we are more than our minds. More than the solitude of sadness or the suffocation of anxiety.

Resourcing – Resourcing is the practice of inviting our mind/body to attune to sensations of safety or goodness, however small they may be. The process of attending to a felt sense of “okay-ness,” can aid in teaching our nervous system that it can experience stress and return to a state of calm. My resourcing involved intentionally bringing my awareness to that of my social community while allowing that awareness to be felt versus merely imagined.

Pendulation – Pendulation is the natural rhythm between states of expansion and contraction in the nervous system. A resilient nervous system is one that can move back and forth between alertness and action, and calm and rest without getting stuck at either extreme. Pendulation on my hike included allowing introspective moments to be interrupted by levity with my friend and fellow hikers.

Titration – Less is more, slow is best. Titration is the allowing of and honoring one’s desire to not disclose, to pause, and to separate throughout the healing process. I view titration as the autonomous ability to allow our healing to unfold naturally.

For many, it may not feel safe or possible to tune into one’s body sensations or felt sense. The felt sense may be seen as a source of trauma, pain, or hatred. So as not to reactivate our nervous system without proper preparation, it’s important to allow for versus demand embodiment. Trauma aware embodiment is marked by autonomy, invitations, and the ability to pause.

Meeting our body’s cues with curiosity can be one conduit for embodiment. I often encourage gentle movement and breathwork throughout the healing process as an invitation towards the embodied self. When noticing feelings of stuckness or judgment and for those who feel safe when engaging in breathwork, we can return again and again to our breath. Finding sources of anchoring and safety in one’s breath can allow us to join our bodies and orient to the present. Gentle embodiment communicates that we can shift the relationship with our bodies from one of contempt and disregard to one of safety and strength.

Reflection Prompts: Allow this to be a gentle reflective process where you can begin to tune into your body and mind.

·       Inviting a few moments of awareness, begin to notice a few body-based stressors (i.e., physical pain, clothing, sensory distress or overload, etc.).

·       Which emotions arise when noticing such sensations and stressors?

·       What might you need to anchor to your felt sense and validate your emotional experience?

·       Inviting you to call to mind ways others have supported you through body-based stress in the past. Noticing sensations linked to memories of support.

·       For each stressor, identify one compassion-based statement to turn towards when in distress. If possible, pairing the statement with gentle breathwork or tension/release movements can be incredibly regulating.

Utilizing moving meditation and reflective journaling can increase our ability to safely settle into ourselves, eventually inviting gentle embodiment. While individual and systematic barriers may discourage particular forms of mind/body awareness, my hope remains that embodiment can one day be seen as an accessible and democratized therapeutic tool. I know that the process of intentionally learning to notice and understand my body’s role in my healing has felt incredibly freeing.

A Thoughtfully Designed & Researched Blueprint of Your Relationship & Marriage

By Concentric Counselors Katie Ho, LPC, NCC & Jennifer Larson, LCPC, NCC

A large part of the human experience, including the joys, losses and challenges, gravitate around relationships. In social and cultural regards, finding a partner and committing to a person can be a marker of happiness, success or accomplishment. But like with any experience, obstacles lay ahead. All couples find themselves navigating conflict, life transitions or faced with heavy decisions, and the related stress that comes with these expected issues.

There are some couples, however, which continue to exist in this perpetual conflict - one that doesn’t appear to have any resolution and creates continual gridlock. Or perhaps there has been a significant breach of trust, or betrayal. Maybe communication is poor, and creates dysfunction during arguments or otherwise, or possibly there has been a traumatic event which has challenged the feelings of safety within the relationship. All of these reasons, and those that might even fall in-between, can be indicators that a couple may benefit from entering couples therapy.

Seeking couples therapy takes courage, as much as it takes hope - hope that the relationship can be repaired or healed, or maybe hope that both individuals can find strength in different directions. Using over 40 years of research, The Gottman Method - developed by Drs. John and Julie Gottman - has helped couples and clinicians create a blueprint of understanding the dysfunction within relationships and the need for building friendship, shared meaning and intimacy. This method was created to serve a deep need in helping find effective intervention for couples looking for repair, healing and happiness. It serves as a theory in which people are able to know both themselves and their partner on a more meaningful level, fostering intimacy, positive affect and skillful conflict management.

When a couple is seeking therapy, there can sometimes be an already significant level of distress present. In their research, the Gottmans found that on average it can take up to 6 years before a couple will seek therapy! This can mean there is a long history of experiences, life phases or challenges that have a need to be explored and understood. Partners may feel overwhelmed, flooded or unsure of where to even begin the healing journey. This highlights the need for a trained couples therapist, equipped with scientific evidence-based practices and the skills to empathize equally with both individuals to help navigate that process.

In working to repair and strengthen a relationship, much like with building a house, there has to be certain core foundational components. The Sound Relationship House from the Gottman Method explains that at its roots, marriage and relationships need to be built on friendship. The essential components of friendship are described as ‘Building Love Maps’, ‘Sharing Fondness and Admiration’ and ‘Turning Towards’. In the first mentioned, to build a Love Map means to truly understand know your partner’s internal world.

People’s internal world changes over time; who are the current people they are involved with, what are their immediate and long-term hopes and dreams, ambitions, or experiences from childhood that may be playing into their current situations. Asking open-ended questions, remembering the answers and actively listening promotes genuine connectedness and friendship. Sharing fondness and admiration, and turning towards your partner, are other components to strengthening and building the friendship of a marriage or relationship. They focus on scanning the environment for what one’s partner is doing right and engaging in appreciation, affection and respect. Additionally, the last level of foundation in ‘turning towards’ describes opportunities for couples to accept and receive bids from the other partner for emotional connection.

The higher levels of The Sound Relationship House include ‘The Positive Perspective’, ‘Manage Conflict’, ‘Make Life Dreams Come True’ and ‘Create Shared Meaning’. These levels of building a healthy relationship are built upon those above-mentioned ideas of friendship. They encompass skills necessary to navigate conflict and life changes, promoting positive affect and a deeper understanding of their partner’s underlying values and dreams and building a life of meaning together. Couples therapy addresses both the necessity for positive connection and friendship, while also acknowledging the dysfunction which makes that task more challenging.

Construction of homes need to be buttressed and supported by its internal supports otherwise houses would collapse.  The same is true of intimate relationships. Every relationship or marriage needs the supports and pillars of 'Trust' and 'Commitment' for stability, safety, and security.  If the 'Trust' or 'Commitment' reinforcements on The Sound Relationship House have been significantly damaged, the relationship can feel shattered and even decimated requiring much repairing and rebuilding.  Sometimes a relationship can be so damaged so that we tell couples relationship #1 has been damaged as if a hurricane or storm came barreling through wiping out your home.  The devastation and trauma is real, but with hope, commitment, and efforts, we can help you re-build relationship #2 as in the case when people experience great natural disaster in their communities requiring building home #2.  Some feel as though it requires blood, sweat and tears, but building relationship #2 can be done collaboratively with the support and care of a highly, skilled and trained couples therapist.   

Having the skills to identify and change maladaptive communication styles and behaviors that plague relationships is of equal value. In our work at Concentric Counseling & Consulting and using the Gottman Method, we incorporate the Four Horsemen of the Apocalypse - which is a metaphor in describing what can be a predictor for the end of a relationship. These include criticism, contempt, defensiveness, and stonewalling. In working with couples to address these maladaptive behaviors, the couples therapist will explain the antidotes, or remedies to address these bad habits in the work towards building healthier ones.

The goal for any couple is to promote understanding, connection, love, growth, and healing. That can look differently for every couple, as every couple experiences their own unique set of challenges and circumstances. The benefit of seeking a therapist trained in a data-driven theory and method such as the Gottman Method is that interventions and treatment plans are tailored to that couples’ needs through the use of thorough assessments and a framework that has been built based on research. The process to having a better, more enjoyable and healthy relationship takes commitment and hard work, but the reward exists within both the outcome and the journey.

For more information on The Gottman Method and services offered by Gottman-trained therapists at Concentric Counseling & Consulting, visit https://www.gottman.com/ and www.concentricchicago.com/couples-marriage-counseling.

A Therapist's New Year's Resolution

By Concentric Owner & Counselor Jennifer Larson, LCPC, NCC

In only a few more days, 2017 will come to a close.  It will be a time to think ahead – many will ignite their New Year’s resolutions.  While I may not routinely come up with New Year’s resolutions, I do think about and write down my personal desires and goals throughout the year.  And, I have decided that I will come up with a New Year’s resolution for 2018.  Before I share my resolution, I would like to share part of my roadmap that has led me to this juncture.

As I have engaged in reflection, I found myself returning back to a perpetual theme that would emerge and re-emerge over this past year.  One particular theme is what I will name as the ‘non-self-disclosing' therapist vs. the 'self-disclosing' therapist wrestling match.  I have no idea when the sport of wrestling season begins and ends, but I can tell you this particular wrestling match has persisted season after season. And, my hope for 2018 is the self-disclosing therapist will take the lead and possibly bring the wrestling match to a close someday soon.     

Let’s start back when these 2 wrestlers first met.  Perhaps they were both first introduced way back when, before the days of graduate school as 'non-self-disclosing' me vs. 'self-disclosing' me.  In my formative years, I grappled with how much to disclose and how much not to disclose my vulnerabilities. And if I did, I chose wisely with a very select few.  Some would say this is normal as we need privacy and boundaries while others may offer a difference of opinion.  Now, let’s fast forward to when I enter into graduate school where I am confronted again with choosing and deciding on how much to disclose.  This time it is focused more on me as an emerging therapist, not me personally.  In the earlier stages of education, students learn about various theoretical orientations and the relevance and implications of non-disclosing and disclosing to one’s clients. 

Just after the start of the millennium, I recall being enthralled with the tug-of-war game that was played during a semester course on ethics.  Our instructor was instrumental in leading the charge on getting all of us graduate students to really explore how to handle ethical dilemmas that can and will mostly likely confront a professional counselor, social worker, or psychologist.  Depending on the topic, some students would sinuously form into 2 teams, tugging and vying for one end (yes, it’s okay to self-disclose to a client; yes, it’s okay to hug certain clients upon closing a session), while the other group pulled and vied in the other direction (no, it’s not okay to self-disclose and hug a client). It was one of my favorite graduate courses as our professor and the course curriculum gave us the space and freedom to think critically and to share our perspectives and beliefs.  Some topics called upon us to unequivocally unite together whereas other topics had students participating in the game of tug-of-war, and well some (ahem) left all of us pooling together in the middle, gray area -- scratching our heads saying, “It just depends, it’s not so black-and-white.”    

Does a therapist merely act as a ‘blank slate’ allowing for one to free associate more easily? Or does a therapist offer some disclosure about their experience and feelings in relation to one’s client (countertransference)?  As therapists, do we divulge some our personal, relatable experiences, such as, “I share the same fear of heights as you do – here are tools that have been helpful to me.”  To disclose or not became even further embedded post graduate school during professional training courses and consultation. And for good reason, this particular topic warrants so much attention in the world of psychotherapy.  I understand the clinical relevance and implications – I get it. 

Over the past 15 years with greater professional and personal life experiences, I have found myself continuing to think about the inquiry of the self-disclosing therapist. At times, I have put forth a tidbit of self-disclosure when I believed it to be ‘clinically appropriate’ or when it simply felt right.  The self-disclosing therapist is not uncommon for some psychotherapists, and it's probably still one of the more debated issues in the field.  Over the past year or so, the inquiry in my mind has expanded beyond the closed doors where therapist-client, supervisor-supervisee, and consultant-consultee relationships are formed, maintained and evolve.  

Questions continue to knock on my door, such as, do I as a therapist share my story (or stories) with others publicly?  Is there value in therapists who choose to open up in a more public forum?  How about us therapists taking our practice even further by exercising vulnerability and using our voice through other outlets?  Are age and credibility in the field some of the salient determinants when choosing to publicly divulge as a professional?  What is too much to self-disclose in written form? Could casting a wider net be detrimental to a therapist’s profession?

While these particular questions have lobbed around in my head for just over a year now; admittedly, they have not been all ‘heady’ taking up rent in my mind.  Sometimes (and many times), I would simply experience this feeling inside of me – near my heart or gut – nudging me to share more and to share with more people.  Stop thinking so much and just take action.  Take the leap and have faith.  Even a call to duty would emerge from within as well.  But why and for what purpose?  The answers didn’t seem readily available to me.  And then over the past few months, it all became clearer.

Earlier in 2017, I learned about On The Table and the #BreakTheSilence initiative by The Kennedy Forum.  I was immediately pulled in as I loved the mission and purpose of this initiative.  Bring people together to give people an opportunity and space to talk about mental health in effort to reduce the stigma that still hovers around and shrouds the already cocoon existence of mental health. The idea is that when more people talk about a topic – in this case mental health and addiction – a positive rippling effect can ensue. 

The more people talk about mental health…

• The easier it will be for all of us to talk about it.

• Better yet, the easier it will be for all of us to talk about it without feeling shame, crazy, or embarrassment.

• The more we will feel safe and free of judgment.

The more people talk about mental health, the more…

• People will seek out help.

• We will honor and view mental health as another facet of humanity and life, just as we do with other areas, such as our physical health.

• We will advocate for change across cultures, families, and even within the helping professional field.

• Opportunity for positive changes within the health care insurance industry.

The continual, cascading effect.  The more people talk about mental health and addiction…

• The more we will become intimate and experience love.

• The more we will be empathic and compassionate.

• The more we will be more understood and connected.

• The healthier we will all become and the more lives will be saved.

Who doesn’t want to experience these things for themselves and others? 

Concentric Counseling & Consulting hosted its first On The Table Discussion on May 16, 2017.  The turn out and experience was inspiring and moving. We even shared people’s stories, experiences and solutions for people to read in our blog.  However, the Concentric’s therapists served as hosts and guides – we were not active participants in this discussion.  No self-disclosing.  This is not a terrible thing, but the knocking on my door didn’t go away.  Should we have re-considered actively participating in this dialogue?  Sharing would mean ‘more people’ talked about mental health and addiction, right? 

There have been other initiatives and movements this year, including one of the more recent ones that started in October 2017. The #MeToo movement gained momentum and traction which has given people collective permission to break free of the shackles that have promoted and reinforced silence, inequality, sexual harassment, discrimination, and assault, shame, and for some, the cocoon existence of mental health. The #MeToo movement encouraged women to share their stories in effort to give people permission to break their silence to unite and to bring greater awareness about the prevalence of sexual misconduct.  The more people talk about their experiences and hardships, the same effects will occur as with the more people talk about mental health and addiction.  Movements like these promote the cascade effect which in turn promote movements – a positive feedback loop. 

All of these experiences along my personal roadtrip have touched and impacted me.  And, while I recognize that I am helping people, I have also recognized that choosing (more times than not) the non-self-disclosing therapist may just not be as helpful.  I believe in the importance of using one’s voice, honoring one’s experiences with integrity and respect, and I want to help become a part of the bigger picture.  I want to talk more about mental health and addiction publicly in effort to help achieve with many others a positive cascade effect.  It won’t be easy for me, that I know. Truthfully, I am not quite sure where to start, what I will disclose about and which platforms to traverse.  What I do know is I now have a clearer understanding of the persistent themes that knocked on my door.  My deeper desires and hopes for all by talking about mental health.

So, my New Year’s resolution for 2018 is for me as a therapist is to start leaning in, to become more of a self-disclosing therapist by sharing more publicly some of my own mental health challenges and triumphs.  Happy New Year Everyone!