What Is Neurodiversity-Affirming Care?

When I tell people that I'm a neurodiversity-affirming or neuroaffirming writing coach, I usually get questioned.

What does neuroaffirming mean? Do you only work with neurodivergent writers? What does neurodiversity mean? And how do you affirm it?

Neuroaffirming care takes into account a person's neurodivergence, and how their brain functions differently from the neurotypical norm; it celebrates those differences while still respecting struggles and providing assistance.

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It takes into account how different brains work, rather than using a one-size-fits-all approach. It views neurodivergences such as autism, depression, ADHD, PTSD, and anxiety as having both strengths and struggles, not just deficits.

Neuroaffirming care does not, however, ignore the real impairments that neurodivergent people face. (I could do with my panic attacks, honestly.) Instead, it sees these people, and neurodiversity itself, as valuable, rather than a thing to eradicate.

Neurodiversity and Its Struggles and Strengths

In an earlier column, I define neurodiversity as normal variations in human neurological function, with an emphasis on normal.

For ease of understanding, I break neurodivergences into three categories: developmental neurodivergences like attention deficit hyperactivity disorder and autism; mental illnesses like bipolar disorder and anxiety; and acquired mental disabilities like post-concussion syndrome and PTSD.

But instead of celebrating these differences, our society penalizes them through discrimination. As I have written previously, our society sees any brain that deviates from a normal brain as wrong, or as broken.

Eugenics and Poor Medical Care

One barrier to finding neuroaffirming care is the history of poor treatment of neurodivergent people.

Our society has a long history of eugenics and neurodiversity. Eugenics is a discredited science that tried to improve the human race by eliminating undesirables (via forced sterilization).

For example, Hans Asperger was an Austrian doctor credited with identifying what we now call autism in the 1930s, and he is recognized for saving these children from Nazis. But new records have emerged that show he collaborated with the Nazis, helping them murder disabled children.

Early 20th-century eugenics casts a long shadow. Today, more research funding is spent on trying to cure neurodivergence than on helping make the lives of neurodivergent people better. Erasing the existence of autism or bipolar disorder at the genetic level is what many call new eugenics.

Because of this past, modern medicine frequently believes that the best way to handle patients' neurodiversity is to ignore it, ask patients to hide it, fear it, or punish behavior. Neurodiversity, in mainstream medical care, is an aggravation, not an intrinsic component of a patient's identity that also deserves care.

Finding Neuroaffirming Care

At its most basic level, neuroaffirming simply means seeing neurodiversity as a good thing and not a bad thing, recognizing that the differences neurodiversity brings to our society improve our society.

Jessie Mewshaw, a pediatric speech and language pathologist who has ADHD, explained to me the difference between neuroaffirming therapy for neurodivergent children and the more widespread (and government-endorsed) compliance-based therapy.

She explained that the goals of compliance-based treatment are “any attempt to modify or change the child to make the people around the child more comfortable.”

On the other hand, neuroaffirming therapies focus on "helping the child to become self-actualized and their authentic self.”

If you are neurodivergent and seeking medical care, therapy, or coaching, it can be hard to find someone who doesn't see your neurodivergence as a problem to be fixed, as Mewshaw described. But it is possible, and affirming providers are out there.

Furthermore, you do not need to be diagnosed as neurodivergent to seek out neuroaffirming care. In an ideal society, every person should receive it.

To find neuroaffirming care, start by simply asking a potential provider if their practice is, indeed, neurodiversity-affirming. If they don't know the word, you can print out this post and give it to them, or just read them the definition.

Neurodiversity Essential Reads

How Therapy Dogs Can Support Neurodiverse College Students

Neurodivergence and the Myth of Laziness

While some providers might not (yet) know the term, many of them nevertheless do affirm neurodiversity. These providers will even be glad to have learned a new word.

As an example, in my practice as a writing coach, I affirm the real struggles that being neurodivergent can cause a writer (procrastination, anyone?) and work on personalized strategies for that writer. After all, neurodivergent people are not monolithic in our challenges.

I also help writers identify their strengths and learn to appreciate them. (Hyperfocus for the win!) After a lifetime of ableism, it can be hard to let go of negative beliefs about yourself. (Those negative beliefs are "internalized ableism.")

In the end, you deserve to be surrounded by people who admire your differences rather than those who would crush them. The world needs the unique perspective you bring. Just remember: every provider you see should be neuroaffirming. You deserve to have your whole self cared for.