If you were ND but didn't realise, and you went to see a psychotherapist and the suspected that you were - would you want to know?

[Blinn]

Name change for this.

I am a trainee psychotherapist and have a client who didn't declare any neurodiversity, however has strong ND traits. Struggles with worrying about "boring" people when talking about their special interest. Always aware if people are talking about their special interest then thinking a lot about how to talk to them about it. Always felt different, is always aware of how they 'present' to others, is a 'different person' in different social situations among other things. Gets overwhelmed and exhausted trying to 'fit in'in social situations.

I have talked to my supervisor and practice manager and they say just meet the client where they are and don't offer advice, which is what I'm currently doing.

I've done some CPD on neurodiversity but that was more about working with clients who are living with ND already.

I really value this client and want to do the best for them. They seem to enjoy the sessions and have told me how much they are helping.

I wondered what people who are ND thought about this?

I would yes

This is how my friend discovered she was Autistic, from a psychotherapist who gently suggested it. She is endlessly grateful as ahe feels she has the right franework to understand herself now and that has greatly improved her mental health.
So yes, gently raise it.

My feeling is that they suspect that they are and I wonder if they subconsciously or not want me to raise it.

If it was within the scope of your practise I would maybe guide them towards it themselves, rather than blurting it out. It all depends on how receptive they would be to it.
I found out I was nd because I attended a sleep study and when meeting the consultant for the results he told me straight out I think you have adhd. I was in shock and laughed but he had me complete the screening tool and I scored very high. Even then I only went along with the assessment out of curiosity... turns out he was right and I have adhd . But there's a difference between a medical doctor and a therapist making these kinds of announcements

Yes I really don't want to break trust. They've had quite a lot of trauma and I know that complex ptsd can sometimes present as ND traits. I am hoping they will come to the realisation themselves.

Sadly it's a limited time service (low cost counselling service) and I only have 6 more weeks with them.

Retired psychotherapist here. The longer you practice the more you will get a feel of how you can take what now will seem like ‘risks’. In the end the best therapy is the authentic, loving connection of two people, and it is the therapist’s willingness to be real with the client and engage fully with their struggle that helps heals the client’s pain and defences.
So evaluate, find your love for the client, and if you feel it will help them, take the leap.
It’s such an honour to be a therapist.

Definitely. No one suggested it to me though. I just knew I wasn't like everyone else and at 35 I asked my doctor if she would refer me.

Thank you so much for that. I have so much love for my clients! I agree, it's an incredible honour.

I've literally had this and it was like a light bulb moment. I was explaining to my therapist how I practice conversational scripts in my head (thinking it was relatable and most people do it) to reduce the unknown aspect of it. She gently suggested ND and gave me some links and recommendations to do the online questionnaire. I was diagnosed with ASD within the same year. I will forever be grateful as I just thought I was 'weird'.

The client does this as well. Thank you.

As a trainee I really think you should do what both your supervisors suggest. They are experienced and have the full picture which we don't.

Everyone is different, but for me, realising that I was autistic at age 60 was totally life-changing, in a good way. I now know that there is a reason I am the way I am and I'm not just weird. I can now give myself permission not to put myself in uncomfortable situations. I am very lucky in that I am fairly 'mildly' autistic, if there is such a thing. I know why I hate being in certain situations, I know why I don't like my food piled up in the middle of my plate artistically, for instance. I am able to deal with things that make me uncomfortable if I have to - I had being doing that for 60 years after all, but I now know that I don't have to most of the time.

however - I know that there are some people who would be offended and upset if you were to tell them they were neuro-diverse, so I would tread very carefully if I were you.

Yes I agree they are far more experienced and I am doing what they suggest so far. However, they don't know my client beyond the initial box ticking exercise.

Agreed.
Or talk it over with them again? Try and understand what their resistance is? There may be a good reason?

I'd be very careful about practicing outside of your training, knowledge and experience. Psychotherapists are not trained diagnosticians in the UK, so you can't say someone definitively has ASD, PTSD or whatever. As a trainee I'd be reflecting on why you felt the need to identify your client as neurodivergent and whether/why that stops you meeting them where they are. You're also doing short term work so won't be there to support them if they react badly to any suggestion you might make, not everyone wants or welcomes a suggestion that they might be neurodiverse.

Sorry, who's resistance? The client hasn't mentioned that they might be autistic.

As a client not therapist I would think it’s ok to suggest not knowing if ND or trauma but that you’ve observed some patterns, especially if it’s a short term relationship. Sooner rather than later so you can start talking about it.

Yes thank you - I am super aware of this.

I agree, talk it over with them. Finding out their reasoning is really good learning for you about how these professional relationships work.

Yes, a thousand times! This happened to me. It made sense of all the years of therapy I'd been through with many other therapists, and why they had never worked.

However, it was said by a therapist I completely trusted and had a very good connection with.

Ah, talking it over with my supervisor- yes I definitely will.

Yes definitely. I wish the various therapists I have seen over the years had mentioned it - although they may not have suspected as a good masker etc. I worked it out for myself but it would have been incredibly helpful if someone had helped me to work this out earlier (and would saved me a lot of money as well as distress...).

I don't think everyone's the same. Some might be offended, others pleased with the insight.

So I think you can't say you seem ND but instead talk about behaviours and how everyone's brain is wired differently.

This is how I figured out I was ND.
Definitely mention it.

What modality are you training in, as that should inform your understanding of your role as a therapist and help guide you.