I have, over recent years, so often had this question in my mind ‘what is neurodivergence and what is trauma?’ I’m sure I’ll come back to it many times, and one of the many helpful things I’m learning from the training I’m doing at the moment is Marie Camin’s suggestion that participants in trauma research probably include lots of unidentified autistic people - so maybe we’re not at a stage it can really be defined or separated. And, as I said yesterday, maybe it doesn’t really matter - as long as we can make sense or meaning of it for ourselves.
One of the comparison points that I have been making, often, in my mind is that of microaggressions and what they do to your sense of safety and sense of self. I learned about microaggressions through
whose TED talk was… well, it was a significant turning point in my life. And her book The Good Ally, a book I return to often, is a seminal text on anti-racism.As Nova describes, so often when we are marginalized - whether because of race, class, physical ability, mental health, neurotype, gender, gender identity, sex, sexuality…any difference that is seen as outside of the very narrow ‘norm’ - it is not the explicit insults or judgements that are harmful (although of course, they are harmful). It’s not even the things said out of naivety or ignorance that are harmful (although of course, they are also harmful). It is also the more subtle statements that are sometimes even said with kindness, or a wish to help, or misunderstanding. Things that leave you feeling wounded but not always quite knowing why.
Through Nova, I learned that microaggressions can cause traumatic stress, which led me to the work of academic psychologist Kevin Nadal and his term ‘microaggressive trauma’: “the excessive and continuous exposure to subtle discrimination (both interpersonal and systemic) and the subsequent symptoms that develop or persist as a result” Nadal describes the ways that therapists will often misinterpret symptoms of trauma, for example treating them as cognitive biases. Other research (e.g. Auguste et al, 2021) has also linked experience of racial microaggressions to symptoms of depression. Also commonly treated as due to negative thought patterns. Rather than sensible and adaptive responses to a hostile environment. And others, such as psychiatrist Helen Minnis, have talked about how stereotyping can so easily influence the treatment approaches we offer or are offered.
When we, as therapists or other professionals, don’t recognise symptoms of trauma for what they are, or interpret an adaptive response to hostility as symptoms of depression, not only do we risk placing the responsibility for responding (appropriately) to stigma and discrimination on those who are stigmatised and discriminated against. We also (strongly) encourage people to return to the environments in which they repeatedly experienced stigma and discrimination. And when they don’t do that, we talk about resistance to treatment. Or, more widely as a society, we talk about a lack of resilience.
Maybe it’s more like death by a thousand cuts.
When people feel unsafe, it is often because they are.
And it is our responsibility - as therapists, as people, as members of society - to create safety for all people.
At the moment, there is a trend for nervous system regulation going around the wellbeing world - vagal tone exercises and somatic practices on my Instagram feed when I pick up my phone. But no amount of humming or cold water is going to change the impact of the things I so frequently hear about the things that make me ‘marginalised’. The big things that are explicitly stigmatising, and the smaller, even well-meaning things that come in as an unexpected stab to the psyche. I can shake them off, but I still brace myself against them and against the anticipation of them from unexpected places.
White privilege, neurotypical privilege, male privilege, class privilege…. all privileges and the intersections between them…give people who hold that privilege the (incorrect) assumption that safety is something that can be created. Sometimes, by the person feeling unsafe.
But safety is felt. And it can’t just be created by the person under siege - unless they just build higher walls or find ways to prevent further attacks. We can find ways to brace ourselves more readily, and even shake things off more quickly - but how do we create spaces where diverse people are able to fully relax in safety? How do we stop the siege in the first place?
Is it even possible? What do you think?
It makes me wonder what are the most common forces / reasons that move people in privilege to help make changes. That doesn’t place the minority or marginalised groups under further obligations. Sometimes it’s not until someone has a personal experience that they feel motivated to become an “ally” or advocate. Like a family member being neurodivergent or LGBTQ+ or other marginalised groups. In some ways social media has been a great driving force in promoting awareness and more spaces where people can articulate and share these kinds of views. But it’s not enough and we see it can be a big performative (if that’s the right word.) maybe as communities grow and come together they will contribute to a changing culture but it requires organisation and intention and determination at a time where people already feel overloaded overwhelmed and tends to fall on people already facing the struggle of being marginalised etc
I keep rereading this post - you've articulated my thoughts so well, both professionally as an OT in perinatal mental health team in a very deprived borough of London where marginalised birthing people are prescribed meds for 'mental illness' rather than tackle the daily realities of families living in one room in inadequate temporary accommodation. Never have I spent so much of my time and practice advocating for the people I work with and liaising with housing, education, DWP, immigration etc. Offering sertaline and a food bank voucher does not increase safety 🙄 Plus they're excluded from accessing psychological services because, I quote, "their social circumstances are too complex" - even though they are the very things contributing to their trauma...
And then personally, I was diagnosed as autistic last year at 42. Now things make much more sense and I can finally stop blaming myself for all the failed attempts at CBT for my extreme noise sensitivity - no amount of carefully planned exposure work will change my physiological response to everyone's barking dogs and year round hot tub parties that everyone seems to have where I live!! It's exhausting having to constantly make adaptations to survive in a neuro typical world when the courtesy is not returned - offering a 'quiet' shopping hour at the crack of dawn in my local shopping centre does not make my community neuro affirming! There's a lot of work that needs doing but I hope my two amazing autistic daughters have a slightly more understanding community - they give me the motivation to keep doing the work.
Sorry for the essay!