Promoting a Neuroception of Safety for Autistic Adults

In order to show up for autistic adults and adults with ADHD, we need to create a safe space to speak of these five truths.

1. Promoting a Neuroception of Safety

Dr. Stephen Porges has coined the term neuroception, which describes how our neural circuits distinguish whether stimuli are safe or dangerous. Specific areas of the brain detect and evaluate features such as body and facial expressions and environmental triggers to evaluate an impression of safety or trustworthiness. In looking through the lens of polyvagal theory we can understand that although an environment may not appear to be threatening (e.g., a noisy, busy, brightly lit lecture theatre), the neuroceptive circuits of a neurodivergent individual may be triggered. A neuroception of safety is necessary before social engagement behaviors can occur.

Neurodivergent individuals are susceptible to emotional contagion (the tendency to absorb, catch, or be influenced by other people’s feelings) and can distinguish very subtle cues that others would not. Professor Tony Attwood described this as a sixth sense and likened this experience to the analogy of a negative tone of voice infecting a neurotypical person at the strength of a cold. In contrast, the neurodivergent individual is infected at the strength of the flu. This can be an overwhelming experience that cannot be easily bypassed. Emotional dismissal can be crippling.

A sense of safety (i.e., a visceral feeling of safety) requires both a reduction of cues of danger and the experience of cues of safety (Porges, 2009). Polyvagal theory provides us with a sophisticated understanding of why focused attunement with another person can shift us out of disorganized and fearful states (Porges, 2009). Demonstrating emotional attunement (a desire to understand and an ability to respect the person’s inner world) further promotes social and emotional development (self-regulation, attachment, and a sense of self).

2. Autonomic States and Co-Regulation

When the autonomic nervous system has moved into a dysregulated dorsal vagal state (shutdown, numbing, disconnection, or dissociation) or sympathetic state (mobilization of fight or flight, survival mode thinking), a quest for safety and connection can be realized by co-regulation (Dana, 2020). Co-regulation is defined as the way in which one person’s autonomic nervous system interacts with another person’s autonomic nervous system in a way that facilitates connection and safety. This involves a recognition of a shift in one’s autonomic state, which is met with a responsive, warm, calming presence and tone of voice. In order to facilitate co-regulation, you need to honor the person's experience (i.e. you are not trying to resolve or escape from the emotion, rather you are emotionally attuned to meeting them where they are at). Co-regulation is dependent upon how the person is seen, heard, held and the ways they are offered safety and connection (Dana, 2020).

3. Accommodations that Look Beyond Behaviours

Dr. Bruce Perry states, “despite the well-documented effects of anger, fear and anxiety on the ability to reason, unhelpful programs tend to ignore the need to engage the safety system of the brain and focus instead on recruiting the cognitive capacities of the mind” (Perry, 2021). Polyvagal theory has enabled us to become more conscious of combining top-down approaches (e.g., promoting new ways of thinking) with bottom-up methods. Bottom-up behaviours are instinctual and require understanding, compassion, and actively helping the individual to feel safe (Delahooke, 2019).

It is important to acknowledge that accommodations need to look beyond behaviours. A client with ADHD who is having difficulty actioning a task will require a comprehensive treatment plan that addresses working with an interest-based nervous system, time blindness, executive functioning concerns, a failure life-trap, etc., and thus strategies of time management will unlikely be successful.

Positive acceptance and understanding of neurodivergence contribute to continued growth, self-awareness, and finding a balance between continuing to work to overcome challenges, whilst also allowing space for a sense of acceptance and willingness to accept accommodations where appropriate. When you build a healthy self-concept, clients are eager to learn and are more likely to develop a self-compassionate mindset to acknowledge that support is vital and needed.

4. Cultivating Self-Compassion

As conceptualised in Buddhist philosophy, Neff (2003) defined the three components of self-compassion as self-kindness, common humanity, and mindfulness (Neff, 2003). The first component of having a self-compassionate stance requires that one is kind and understanding towards oneself when failure, inadequacy, or misfortune is experienced (Neff, 2005).

The second component of self-compassion, defined as "common humanity," originates from the proposition that “healthy and constructive self-attitudes stem in part from de-emphasising the separate self, rather than merely building up and solidifying one’s separate and unique identity” (Neff, 2003; 96). The common humanity component of self-compassion allows for the recognition of the related experiences of the self and other, in which pain and imperfection are acknowledged as an inevitable part of the human experience, as opposed to isolated occurrences that only happen to one alone (Neff, 2005). By focusing on the interconnected aspects of experience an individual high in self-compassion acknowledges that all human beings fail and experience pain.

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The third component of self-compassion, defined as "mindfulness," requires taking a balanced approach to our negative emotions so that feelings are neither suppressed nor exaggerated (Neff, 2003). Mindfulness requires a willingness to observe one’s negative thoughts and feelings in a non-judgmental receptive mind-state of openness and clarity, without trying to suppress or deny them.

5. Cultivating Authenticity

The diagnostic and statistical manual of mental health disorders offers standard criteria for the classification of disorders. This information is essential for providing a toolbox of coping skills to treat mental health concerns. Personalising treatment for precision goes beyond challenging thinking and treating avoidance behaviours to allow people to embrace their authentic self.

The discipline of psychology is evolving at a rapid pace, with a move away from the idea that people need to meet neuro-normative expectations in order to succeed in life. A great tragedy is going through life disconnected from our brilliant minds because we see the self as broken. Blocking your emotions and masking (repression of emotion and camouflaging) can lead to burnout and is particularly adverse for mental health (anxiety, depression), self-perception and self-esteem. Time spent without "masking" and a passage of time to recover may be needed.

An important first step to removing the mask is one of acceptance, before we can identify and embrace the many strengths and beauty of the person. When we can come to accept our whole selves, we can remove the mask that makes us feel hidden, rejected, and disconnected. You don’t grow out of the way your mind works—rather, you grow into it.