Dual identities

'What does it mean?'

Dr Emma Svanberg, Clinical Psychologist and author of Parenting for Humans.

It's the question we ask so often as psychologists, isn't it? In so many different ways. 'What does that mean to you?' 'Why? Where did you learn that meaning? Who did you learn that meaning from?' 'How does it affect you, this particular way of making meaning?'

I've asked that question a lot over the last few years as I discovered neurodivergence – as a concept but also as it applied to me. Beginning to understand neurodivergence was a bit like opening a door to a whole world (and community) that I didn't know existed – but one where I instinctively knew the language and felt very comfortable with the culture. 
I mean, where else can you cut out all the time-wasting small talk and go straight to talking about community, inequality, trauma, politics, history, society?

One other place. With psychologists.

As I started to untangle my diagnosis, one question has been how did it take me so long to realise? Because the more I've discovered about autism, the more it feels like the word 'Autistic' should be written in flashing neon letters above me. And one of the main reasons I – and those around me – never realised was because I was given language to successfully camouflage my autistic traits without anyone knowing that was happening.

I work with parents, so of course I make meaning by considering my own upbringing. I'm the child of two people who were born in very different cultures to each other, outside of the UK. They came here in the 1970s with English as their shared language, and English was the only language we spoke at home. I was brought up in Newcastle upon Tyne and was one of only two people I knew with a similar heritage and upbringing to me. The other one is my sister.

This meant that we had to figure out – sometimes individually, sometimes as a family – what the rules were in different contexts, which could be novel to us all. This is a skill I feel like I really mastered (most of the time) – becoming a detective of social acceptability in different situations. And these skills were honed with psychology, which gives you a language to understand people. It also gives you neat little models that explain the complexity of human beings, especially to those of us who are good at spotting patterns. Tools with which to make life feel more comprehensible.

And sometimes to hide behind. Because it's generally socially acceptable for a person who happens to be a psychologist to ask curious questions about why something is happening and what something means. And the worst response is usually to 'stop being such a psychologist', rather than the multiple other more catastrophic outcomes my busy mind has dreamed up over the years.

I've learned to hold those tools much more loosely now though. Honestly – they're a bit blunt. And sometimes exhausting to use. And sometimes (often?) not the right tool for the job.

Because if there's anything I've learned about autism from the neurodivergent community, it's that many of those models we like to use to make life feel a bit neater are just, kind of, maybe, wrong. Some people can't fit neatly into boxes. They need to create their own boxes, their own languages, their own worlds. And, as psychologists, we need to become much more comfortable with learning that we are often just visitors.

'I collect people'

Anita Marsden is working towards more neuroaffirmative practice within the NHS, in a Community Paediatric setting.

I've taken this opportunity to write a bit about my dual identity as a psychologist and as a neurodivergent person. I was unsure and reluctant, but reading others' stories, I feel there is importance in sharing experiences, in listening to each other, widening our understanding, challenging our preconceptions and recognising the change-making potential of raising our narratives, both to ourselves and others.

I have always had a special interest, in people, in relationships, and as a teenager, my family may have described this as an obsession (my diaries evidence this). I collect people; if you have known me in the past, chances are you still know me now. And, perhaps accidentally (thanks to my A-level Psychology teacher), my special interest became neurodivergence (alongside mental health), an interest which has followed me through my education, research, training and employment ever since. At this point in my career, I am so very grateful that this has been the focus of my professional life.

In brief, I was diagnosed as dyslexic at university. I would also have met the criteria for Generalised Anxiety Disorder (GAD), but my GP only prescribed sleeping tablets with no signposting or recommendations. Reflecting back on my dyslexia assessment (being able to interpret it now), I can see they didn't consider the impact of my anxiety or differential diagnoses such as ADHD. Following completion of my clinical training, I have worked in neurodevelopmental diagnostic services and recognise historically I have entertained a 'them and us' view, othering those I am assessing. However, more recently, as I have journeyed towards my own neurodivergence, I am moving towards just an 'us' perspective.

I guess my dyslexia diagnosis would already place me in the neurodivergent bracket (as I struggle to write this coherently), but more recently I have identified that I will likely meet the criteria for ADHD (awaiting assessment) and even more recently, that many of my experiences align with the autistic experience. Identifying autism in my immediate family has been a significant factor in identifying these characteristics in myself (I am currently grappling with the 'broad autism phenotype' vs just being autistic).

There is so much more to say, but I want to make two important professional points.

Firstly, in diagnostic (or assessment) work, it is important to consider our own 'profile' and what we bring to the assessment (autism is transactional, as Jonathan Green discusses in his conversation in this edition). Considering diagnosing through the double empathy problem (Damian Milton), I now can look back and see young people where I had the clinical impression that they were not autistic because our social communication was 'matched' and the rapport aligned (they felt safe and so we weren't seeing some of those autistic characteristics under stress the Autism Diagnostic Observation Schedule (ADOS) measures).

Secondly, experiences within my family have highlighted the potential but significant downstream effects of being neurodivergent and in tricky or disabling environments. We know the impact of chronic and toxic stress, but I fear we are not taking seriously enough the impact this is having on neurodivergent children and their developing brains. In my therapeutic work, I am seeing very young children who are burnt out. Luke Beardon has written an interesting book called Avoiding Anxiety in Autistic Children, which emphasises the damaging effect of anxiety and challenges some of our traditional 'exposure' models of anxiety.

In summary, journeying towards my own neurodivergence has felt serendipitous and important. I'm recognising my strengths: my ability to form relationships, to feel others' emotions, to fight for social justice, to raise my voice even when it might not be the done thing. I know I am a better person (and professional) for embracing my differences and supporting others to celebrate theirs too.

'I was learning how I could make the profession fit my identity'

Kyah Sisulu is a guest editor: see her bio in their introduction.

During my training as a clinical psychologist, I did a six-month placement during which I was the lead psychologist on the pre-school autism diagnostic team. As a member of the autistic community myself, this was an interesting experience.

The average wait for an autism assessment is around 18 months. Many people hope and anticipate that the assessment will finally lead to them feeling supported, validated, and heard, after years of feeling misunderstood, out of place and stigmatised. However, in too many cases, parents and adults experience an assessment that invalidates their experiences and fails to recognise their autistic traits, masking, trauma and challenges they experience.

I argue that this is due to assessors looking for stereotypical signs of autism and neurotypical signs of distress. Many working-age adults have been deemed too capable to meet the diagnostic criteria despite the exhaustion, shut-down and burn-out they frequently experience from masking. How can you be autistic when your job is to communicate with others? As studies led by Georgia Lockwood-Estrin and by David Mandell suggest, People of Colour and female-identifying people are often misdiagnosed and often have their mental health questioned during autism assessments, with psychiatrists asking whether they have considered Bipolar or Borderline Personality Disorder instead, overlooking their neurodivergence.

Some diagnostic services are at capacity and experience systemic pressures that cause them to misdiagnose people who do not show obvious or neurotypical signs of struggling, hoping those who 'really need' support will appeal the decision. As with the benefits system, many people may not have the capacity or resources for this and can feel invalidated, belittled, hopeless, and worse than before their assessment. Thankfully, not all assessments or assessment services are like this, and I observed that neuroaffirmative diagnostic services do exist!

Parents I worked with during my placement had different perceptions around identifying their child as autistic. Many parents were anxious about 'labelling' their child, concerned whether their child would have fewer opportunities and were unsure what the benefits of a diagnosis would be. In the South West, many parents worried that identifying as autistic would prevent their child from being in the army.

In contrast, many parents were determined to get a formal autism diagnosis. These parents often expressed feeling a huge power imbalance before the assessment, saying that they would identify their child as autistic regardless of the assessment outcome. My own experiences in the autistic community helped me to understand these power imbalances, the value of self-diagnosing and the anxiety parents and families experience. I reassured them that the parent interview was a chance for them to share their experiences, which would be valued by the team. I saw the families as parents, grandparents, carers, and siblings who have had to fight to meet their family's needs, rather than 'angry, defensive and difficult' parents.

The 'Double empathy' concept, coined by Damian Milton and colleagues, might suggest that a neurotypical clinician may struggle to empathise with autistic experiences. As a neurodivergent woman and a carer of neurodivergent family members, I was better able to recognise autism through the families' stories. I could identify experiences such as masking, sensory sensitivities and coping strategies, and explore these with the family. At times, this helped leave the family with a deeper understanding of their child's needs. For example, we explored sensitivities such as clothing texture or teeth brushing rather than only identifying stereotypical sensory sensitivities such as loud noises, whilst modelling a reflective approach to understanding their child's internal world.

A key learning point on this placement was to balance modelling neuroaffirmative practices with validating and attuning to the families' varying emotional experiences. For example, a parent might have expressed frustration and confusion at their child reciting animal names repetitively, whereas I was experiencing respect and delight at the child's ability to self-regulate, enjoy their interests or their impressive memory. 

It was important I validate how frustrating it can be when these things impact upon the parents' responsibilities and interfere with the expectations of daily life, whilst explaining why their child might be doing them. When learning about their child's inner world, parents often expressed relief and realisation. Parents who'd been exposed to more neuroaffirmative ideas experienced less difficult emotions due to having more understanding of autism and, with that, a greater sense of control and empowerment.

I found that writing, and sometimes rephrasing, parents' experiences in the report could also help explain those inner worlds. Signposting to services and resources throughout the assessment also gave the family immediate tools while they waited for the report. The report could be a great tool to help with benefits applications, Education Health Care Plans (EHCPs), and any other support the family needed. On a few occasions, I also used the report to challenge negative perceptions that services and systems held about a family or parent, hopefully improving their future experiences with services. Both myself and the parents were pleasantly surprised that the autism assessment report could serve more purposes than providing a formal diagnosis.

I also saw the value of my role in championing the basic needs of children and families. It would be doing the families a disservice not to mention the common experiences families shared. Many families were in housing that was not adequate for their family's size, with risk and distress increased by autistic children sharing bedrooms with multiple siblings or lacking outdoor space. Many shared how often they had been rejected for personal independent payments and carers allowance. Many did not have higher rate mobility payments despite struggles with daily living such as shopping, getting children to school or attending appointments. Due to my own experiences with the benefits system, I was able to inform them as to how they might use the report to support their applications.

Stories were often told of their child needing hospital care but doctors refusing to allow parents to aid their child's communication due to fears around safeguarding, or medical professionals not listening to parents regarding their child's communicational or sensory needs, sometimes even with hospital passports. Similarly, parents often reported being told their child did not qualify for an EHCP without a diagnosis, despite the child showing a high level of need and struggling in their school environment, leaving parents feeling ignored, judged and labelled as a 'difficult' when expressing their child's needs.

Lastly, it was impossible not to notice the chasm where children of colour should have been. The majority of children being diagnosed in the service were white British or from a white European background. Not surprisingly, I did not support any People of Colour in the South West until working in forensic services. Despite this partly being geographical, it links to the argument around decolonising autism research to support young people to access autism diagnoses rather than more stigmatised diagnoses such as 'Oppositional Defiant Disorder' and 'Conduct Disorder'.

I have alluded to how my intersecting identities impacted me in this role, particularly highlighting the benefits and challenges of being a member of the autistic community. However, my identity is more than that of a dual identity. As a Mixed Black British Queer Neurodivergent woman from a working-class background, many aspects of my identity supported me in this role, and some impacted me negatively.

I did find it challenging to manage my own identity as a Black Psychologist in a field that has only just started to consider diversifying its workforce. Being an activist with intersecting identities in a workforce that lacks inclusion means that I will often be offering a different perspective and challenging cultures. Although I always attempt to 'walk alongside' while doing this, it is okay if this occasionally leaves some people feeling the discomfort I feel following racist, sexist, homophobic or ableist comments.

Although I was the only Person of Colour on the team, the service was very inclusive. However, not surprisingly, I do experience microaggressions in other aspects of the course and living in the South West, so my first year of training was mostly learning how to navigate what kind of psychologist I wanted to be and how I could make the profession fit my identity, rather than shape my identity to fit the profession. I did not have to mask as much as a neurodivergent person, nor did I need to mask as much as a black person either, allowing me to focus on learning, developing and being the best clinician I can be.

Ironically, writing this is an excellent example of the challenge of having dual or intersecting identities. Historically, psychology has discouraged self-disclosure and refused to acknowledge how our identities impact our work. I have tried to balance my lived and professional experiences, but have also found it hard to decide how my intersecting identities are relevant to being a neurodivergent diagnostician, and to reflect on something I am still learning about and shaping every day.

Overall, working with the neurodivergent community as a part of that community has only ever helped me and those I have supported. Yes, there are times when an extra level of reflection is needed to manage my own biases. Still, the benefits of being able to empathise with the neurodivergent community outweigh these challenges. I am hopeful that we can dispel the myth that neurodivergent people, and other minoritised and stigmatised groups, cannot be clinicians. We must create a diverse and inclusive workforce that represents the communities we support, in all aspects of our intersecting identities.

'Inside I had a vision of who I could be'

Linda Hannah (she/her) is a Registered Mental Health Nurse and Registered General Nurse, or RMN RGN, and works as an Older Person's Mental Health Liaison Nurse at St Richards Hospital Chichester, which encompasses both qualifications.

I sustained a traumatic head injury when I was 15-months-old. I was in the car seat hooked over the passenger seat, and I clunked my head on the metal tray. I had five days in hospital, hairline skull fracture, concussion. For six months after, I was on Phenobarbitone for seizure prevention.

That was July 1961. Considering attitudes and knowledge of post head injuries at the time, I do not know what the expectations were, of how I would grow and develop and if there would be any residual deficits. Likely no-one knew. But my parents and Grandparents said I was not the same afterwards.

I have no idea what they noticed, I never asked.

I was just me, the usual normal me.

The older I became the more the deficits showed, but were ignored, misunderstood. My earliest memory of this was when I was about four. I was at nursery where we had workbooks to go through. There was space to draw a picture, and as I recall the theme was stated. I looked at this box, pencil in my hand and nothing would come to my head, my hand. The teacher came, I told her but she did not sit, help, wonder what or why. She walked away.

I was always quiet in class, outside of class, did not join the gaggle to the playground. I was lonely, and school work was at times impossible to concentrate on. Where others could put their hand in the air and go 'Miss! Miss! Can you help' because they knew where they were stuck, I just got lost and did not know what to ask. The labels 'slow' and 'lazy' were thrown at me by teachers. At 45 I was assessed as having Dyslexia, as I had slow processing and a poor working memory, but my spelling was always good, and my grammar too.

My wish was to be a nurse, and when my Mother took my brother, sister and I to the library I went into the adult section to look at the nursing books, going through the pictures. There was one where the nurse was helping a lady drink from a cup, people being helped to walk, patients in iron lung machines. I wanted to be a nurse, but I do not know where this came from. On the one hand I am being judged and dismissed by my parents, teachers, peers because I am not this, or that, but inside of me I had a vision of who I could be, and she was not in the Children's Section.

My school life continued in a similar vein. The best a teacher could come up with was 'Linda is an enigma' (said to my Mother). The underlying cause, issue, reason was not disclosed to anyone outside the family as far as I was aware. My wish to be a nurse was not thought an option, going through the training and achieving the qualification; 'you're not responsible enough', said my Mother.

After leaving school and college with not much in the way of stuff to put on a CV, we as a family moved; I was unemployed and adrift. I ended up doing some voluntary work at the nearby Psychiatric Hospital (Graylingwell) in the shop, serving tea and biscuits to patients who had received Electro-Convulsive Therapy and were somewhat woozy post treatment.

At that time, I saw patients who were brought in with low mood and agitation, feeling awful, but over the next couple of weeks or as they had the course they improved so much. One of the Nursing Officers who used to pop in the shop said he had posts going in his unit for nursing assistants if I wanted to apply. I did, and worked on the elderly wards that had students. After a couple of months, I was asked if I wanted to do my training; I knew this was my chance.

The training was a steep learning curve but a different kind of learning to the focused intensity of class learning, although there were allotted weeks at the School of Nursing. My training was experiential and like an apprenticeship. It was not easy. Some placements were better than others. I worked hard, did two extra qualifications as well and I passed everything. I wonder if there were those who doubted that I would, that I may have to re-sit my Registered Mental Health Nurse (RMN) finals.

One of the main areas I was pulled up on was being unassertive; that old feature that seems to have followed me in its various guises. This has not gone away, but there have been times when it has been easier. It has depended on the personality power my colleagues have paraded. I have worked better where I have autonomy and can work at my own pace, my way, my world, in my head space.

I have had some pretty torrid times with courses along the way and had to give up. But I have built good patient rapports, sometimes where others have failed to or did not hear or see what I did, and in creative ways like using a sensory room. This was not unusual at all, I made better connections in how I worked and patients appreciated this. I would often say 'yes' when others would roll the tumbleweed; a consultant said he liked my 'can do attitude'.

To those who peered at me over their glasses, tutted and judged, I run with a traumatic brain injury, I am a nurse, doubly qualified as a Registered Mental Health Nurse (RMN) and Registered General Nurse (RGN).

'I know who I want to be'

Dr Pip Wood is a recently qualified autistic Clinical Psychologist with interests in neurodiversity, gender and sexuality. This extract is from a reflective piece written at the end of their training at Plymouth University.

Throughout my life, I have always been labelled as 'the quiet one' or 'too sensitive', being discouraged from pursuing a career in Mental Health Nursing because of my inherent sensitivity. A more academic undergraduate degree in psychology was considered appropriate and now my sensitivity and compassion are assets to my job. But growing up, my sensitivity felt like a burden; I was bullied by my 'friends', taken advantage of and spent most of my time trying to work out how to make people like me. I thought I was doing everything right but the reality of it was that I couldn't understand the nuances of social rules and struggled when what I was 'supposed' to do was unclear. In 2022 I was diagnosed as autistic, and I started to understand myself from a whole new perspective.

My doctoral research, entitled "Through Our Eyes: Understanding How Autistic Children Co-Author a Sense of Self and Relate to the World" focused on hearing the voices of those lesser heard. It was a pivotal part of my own journey in finally seeing myself for who I truly am and has allowed me to advocate for not only myself, but others too. Diagnosis has enabled me to feel more comfortable with myself and my differences. But I've had to come to this realisation on my own. It is not easy to live in a world where those around you do not understand your needs. I feel frustrated that I have to advocate for my rights to access education, clinical support and aspects of daily life and still be faced with "but you don't look autistic".

I start this piece with a diagnostic disclosure because when I started my research journey, I did not know I was autistic. My interest in autism as a neurodevelopmental condition has been prevalent since before I started the doctorate. However, my perspective has evolved over the three years and has been influenced by my context. Within my first-year placement, I was in a service predominantly using the term 'ASD' when speaking about autism, referring to the diagnostic label Autism Spectrum Disorder. I did not question this. In fact, my reflective diary indicates that I used the term myself. By my first research bracketing interview, over 9 months later, I had developed my knowledge around terminology and started using 'ASC' (as in Autistic Spectrum Condition). Now, I do not use either term, personally preferring to use simply 'autism'.

Stuck Between Diagnosis and Difference

Throughout my research journey, I have been able to identify where I may become 'stuck' and recognise a personal preference towards a neurodiversity perspective rather than a medicalised, diagnostic one. This is despite having sought out an autism assessment for myself, aged 28. This process allowed me to explore a dual lens whereby diagnosis may be necessary within our social context but that a disability or deficit framework may well be harmful. I can hold these views about myself whilst also acknowledging that for some autistic people, a disability narrative is one which is beneficial and helpful.

This research has made me more aware of how context and relationships can inform views. The narratives or stories we are told, influence us both consciously and unconsciously. I have always strived to 'fit in' and am guilty of trying to form an identity in line with those around me. Whilst I have not always been aware of this, my perspective on diagnoses as a concept has varied throughout my life.

I have always had a complex relationship with 'labels'; at times the idea of fitting a particular stereotype or societal group has felt comforting, whilst other times I enjoy being free to be myself unconstricted by binaries. However, labels (and thus, diagnoses) do have a place in our society. It is a way to make sense of things, identify characteristics in one another and feel part of a 'group'. As social mammals, it is reasonable for us as humans to strive to 'fit in'. At the same time, labels can fuel misunderstanding, stereotypes and be used to push others away from what is conceived as 'normal'.

Seeing myself through autistic glasses

I am angry that it feels difficult for individuals like me to be viewed as 'good psychologists'. Why is it that neurodiversity is steadily gaining mainstream recognition and yet we still need to be having conversations about the acceptance of difference and advocating for change within our profession? On the first day of clinical training, we were told that psychologists need to be open to change and address inclusion and diversity. Yet, outdated, painful and ableist assumptions mar our past and corrupt our futures because autism is a "global health crisis" and viewed through a pathology paradigm.

This concept is harmful and perpetuates an inability to view neurodiversity using a strengths-based approach. I want to change this. For myself and for others. This is why my research is important and why research done by autistic researchers is essential. There is an unequal distribution of power in society and how we use our own power is just as important. I have used my privilege and power to conduct this research.

I didn't always start out with this view, however. My research initially started out as a clinical interest in 'autism identity' resulting from working with late-diagnosed autistic individuals or those seeking diagnosis as adolescents. Whilst part of me knew I was 'different' and had an affiliation with neurodiverse individuals, myself as autistic is an identity I have adopted over the course of this research. In July 2022, one month after my autism diagnosis, I wrote the following in my research journal:

I now have an autism diagnosis which I will have to be aware of going forward in my research. Whilst I agree with it, I do not feel as though I am emotionally attached to the label which I hope will aid me in not reacting adversely to things that may come up.

Looking back on this now, I find myself mildly amused and somewhat bemused; my affiliation with autism and a sense of difference is stronger because of this research. I have learnt a new language and felt more comfortable in my own experience.

'Resilience'

It can be hard to articulate the difficulties experienced whilst on training because these challenges represent more than a disparity in university staffing and capacity for support and supervision. Singular events add up and collectively mirrored so many of my life experiences where I didn't 'fit in', where people were not interested in the things I was; I was not important.

Perhaps more hurtful for me was the lack of supervision accessible to me for my research project. Not only was I not important but neither were the individuals I wanted to work with. I did not know then that I am also autistic. Looking back on this now perhaps feels worse because I can see how lost and isolated I was. I felt as though I was in the wrong. I wasn't working hard enough. I wasn't enough. I was too sensitive.

My strategy for coping was to overcompensate. If I was unsupported, then the problem was me. An individual. I worked myself to the ground. In fact, I became extremely unwell. As an undiagnosed autistic person in the world of clinical psychology, I was floundering. My honesty and candour about my own lived experiences was overlooked as 'resilience' and 'coping' when really, I needed someone to throw me a line.

The illusion

There is an illusion that the stigma of mental illness no longer exists. The reality is that it is now hidden in plain sight. Despite the prominence of social media campaigns to "be kind" and normalise talking about our mental health and well-being it can still be quite detrimental to do so in certain situations. As a working professional, it can be problematic to disclose difficulties. The juxtaposition of this view and that of the doctoral training is not lost on me.

It is encouraged that we reflect on their own experiences as well as thoughts reactions and behaviours in reaction to people situations and topics. Naming my lived experiences of trauma and mental health was a core aspect of my doctoral application and interview. As such, my view is that the University of Plymouth knowingly accepted me onto the training, seeing value in this knowledge and with a view of nurturing this.

I chose this course as it was at the forefront of conversations of inclusion, power, and diversity, valuing those in minoritised groups and actively engaging in 'the work' to increase positive experiences both for those we work with and of doctoral training. Over the two years this view of being valued has seemed to transition to an experience of being accepted despite my experiences.

I thought training would be really progressive and inclusive and empowering to shape the next generation of psychologists. Instead, at times, it has been harmful, discriminatory, and unsafe. My difficulties are not in isolation. They are not an individualised 'autism' problem. My cohort are kind, thoughtful, compassionate, and ardent psychologists. I am proud of us. I believe we can make a change and I am hopeful that mine, and their, research will contribute to this.

It's systemic!

My experiences are not in isolation but the impact of my needs not being met parallels with structural oppression within society. Autistic individuals often internalise their difficulties within a neurotypical society. We are in a world that pathologises us when we struggle. Developing accessible research methodologies, creative therapies and holistic family support and understanding should not be difficult.

My research has helped me to recognise factors in autism understanding that need addressing. There are systemic processes, structures and policies that perpetuate inequalities and discrimination. I have power. I have a voice. I want to use it to work towards nurturing and compassionate systems of accountability.

I may not have received adequate support for the first two years of my research journey, but these difficulties have made this achievement feel vindicating. I did it. Myself. I am good enough. But I am tired. I am hurt. This has been the hardest three years of my adult life. I am slowly learning to be more authentically myself and not mask unnecessarily. I am teaching myself to love who I am, and I know who I want to be. As a researcher. As a clinician. And as a human being.

Being me

As an autistic clinician, I find that my own experiences enhance my ability to work with service users and develop strong therapeutic relationships. I refuse to let my own experiences be a barrier to my work but accept what they can teach us and fuel the fire that helps me to become a better person and ultimately, a better clinician.

Power

I have been reflecting on the parallels of my experience of systems around me to my participants and their families. I have been reminded me about what it feels like to be stuck in a system that views difficulties as an individual problem and authenticates a deficit, blaming narrative. My experiences of discrimination and oppression are a stark reminder of what it feels like to be in a vulnerable position and feel (subjectively) punished for it. I am still recovering from this. However, I have been able to consider the power I hold within my role and the privileges I am afforded to be able to reflect on my own crisis in this way.

I am angry on behalf of those feeling powerless against the system and are struggling against policy, procedure, waiting lists and exclusion criteria to be heard. I wanted to become a clinical psychologist because I wanted to hear the voices of those not listened to. I have always been that person that notices small things and using that in my work feels integral to me. I want to be a clinician who gives service users a good experience of professionals, to be a step in their journey and allowing them to feel able to move forward.

Not only that but I felt a passion for having conversations about the importance and beauty of diversity. All these things, I am now more determined to achieve. Whilst this time has been painful and hurtful at times, I am grateful for what it has taught me. I know more now about the psychologist I want to become and why. Gabor Maté said in one of his books "we can't let our experiences be barriers to our work" (Maté, 2011) and I agree, but we can let what they teach us fuel the fire that helps us become better people and ultimately, better clinicians and researchers.

I will not apologise

For me, now I understand myself that bit better, autism is inseparable from 'me'. There is no 'with autism' for me. Perhaps that's why, clinically, this research journey has been so impactful. I am not ashamed to be the psychologist I am. No more trying to fit in and dress like a psychologist should; I've never looked good in a floral dress, blazer, and heels! I represent several minority groups. I have tattoos, piercings, wear odd socks, dye my hair fun colours, and love a garish patterned shirt or dungarees. If I can be a clinician who can level with a service user, and be genuinely human, then that is enough. I am enough.

My research taught me a lot about myself and how I view the world. There is a lot I would do differently, and I hope I get the chance to continue in this line of research after qualification. In my research I quote an autistic parent of an autistic child who viewed themselves as a constellation of stars across a sky who just needed to find the language for their clusters. As individuals, we are all a diverse map of stars with some maintaining an even distribution and others with larger clusters across a smaller expanse of space. If there were more acceptance of the beauty of this diversity, perhaps individuals would feel more empowered to own their difference, creating more inclusive environments for all. I will not apologise for who I am anymore.

Reference

Maté, G. (2011). When the body says no: The cost of hidden stress. Vintage Canada.

Image above: 

Sharif Persaud, Self Portrait, acrylic on paper

Project Art Works