Creating a Neurodivergent Affirmative Supervision

hannahctherapy
Oct 11
9 min read

Until I began training as an Anti-oppressive (AO) Supervisor, I genuinely believed supervision needed to be hierarchical to be effective — that a clear power dynamic was essential. I see things very differently now. The readings I have absorbed offer a different perspective, where egalitarianism and mutuality is the norm. While Supervisors do hold significant power and responsibility, I personally want to use that power to create something better for neurodivergent (Nd) Supervisees

Thinking about power always brings me back to the assertion that:

“There is no point where you are free from all power relations. But you can always change it… This does not mean that we are always trapped, but that we are always free… there is always the possibility of changing.” [1]

Foucault

I have included images of nature in this piece to invoke a spirit of expansiveness, spaciousness and change ....and because visual stimulus is great for Nd brains!

Wider societal context

My current understanding of Nd is based on the idea that neurological ‘differences’—like autism, ADHD, dyslexia—are natural variations of the human brain, not disorders to be "fixed." The image below shows how Nd can encapsulate a variety of different conditions:

Considering that under UK law[2], the definition of disability is a “physical or mental impairment that has a substantial, long-term, and adverse effect on their day-to-day activities;”. I believe having ADHD is a disability. Not all Nd people will agree, and I would welcome other perspectives in the supervision space.

Reframing Power and Oppression

As a white, Nd Supervisor, I know my work must include anti-racist, intercultural, and disability justice principles to truly be Anti-oppressive. Nd-affirmative supervision can mirror the principles of ‘culturally sensitive supervision’. Brown, in his chapter in Intercultural Supervision, describes culturally sensitive supervision as a space that understands dominant pedagogical concepts and cultural values (like eye contact equals connection) are not normative or universal. Knowledge of this, Brown argues, may help to ensure that these concepts/values are not transmitted to Supervisees.

Being intentional and aware of what messages I pass on to my Supervisees feels key here. I feel that unless I am intentional, I will make mistakes which will perpetuate a one-size-fits-all approach to clinical supervision. As all forms of oppression are linked, it is important to acknowledge the connection between institutional racism and institutional ableism. I understand that disabled Supervisees who are from global majority backgrounds may often experience ‘double discrimination’ due to the impact of racism and disability related discrimination. That experience can be a lot for a soul and a body to hold, especially in relation to how they hold their clients. There is little acknowledgement of this in mainstream Supervision theory.

Challenging the Neurotypical Norm

Creating a truly Nd safe supervision means creating a space to unmask, a space to be honest, and a space to declare ‘we can do things differently here’. The lack of acknowledgement for Nd in my counselling training means that I was taught a strict, neurotypical framework of counselling, and this was mirrored in the Supervision spaces I attended.

Being passionate about avoiding harm as a Clinical Supervision means acknowledging and challenging the messaging I internalised as an existentially trained counsellor. These messages were essentially:

· be still, sit, listen

· don’t share who you are

· don’t talk over the client

· difference isn't important

· diversity is secondary to theory

· the ‘norm’ is neurotypical.

These messages frustrated me then, and they frustrate me now!

Learning from the mistakes of our contemporaries means acknowledging the harm that pushing through, adapting, performing, or masking can have on Nd Supervisees. These practices had a detrimental effect on my physical and mental health, and yet I find they are still a go-to, conditioned response as a trainee Supervisor! If this goes unchecked, then I am passing this oppressive idea of a false ‘norm’ on to my Supervisees and the cycle continues.

Ableism (discrimination in favour of non-disabled people) can manifest in many ways in the supervisory relationship. Masking (the conscious or unconscious attempt to hide Nd) is often detrimental to an individual’s mental health. This makes me wonder, how can we promote good mental health if we are encouraging masking practices in the Supervision space? Supervisors may encourage Supervisees to mask due to our expectations regarding verbal and non-verbal communication that exist within counselling supervision (like the expectation and pathologisation of eye contact, for example). Supervision may be the only place where Supervisee get reassurance regarding their work with clients, and so I feel it is integral that the space is free of harmful ableist practices.

My Personal Context

Having undiagnosed (and untreated) ADHD during my counselling placement and qualification meant that I struggled to understand why I found some aspects of the profession harder than my peers, even though I felt I could attune well emotionally, and I was told I had a deep level of empathic awareness. But I still felt like an outsider. As a Queer Irish immigrant, I already held a different perspective on themes of power, culture and identity than the majority of my white cishet British peers. Not knowing why meant I internalised the idea that I was doing something ‘wrong’.

Training as a clinical Supervisor has brought this experience up for me again as I re-engage with theory that is:

“founded and advanced almost exclusively by White men, most theories, and frameworks on which the counselling profession was built and are performed center on the White, Western, Christian, middle-class, cisgender, heterosexual, male, neurotypical, able-bodied, and colonized experiences as the way of knowing, and as the norms from which all “others” are given meaning [3]”.

The impact of the idea that one group holds the ‘norm’ is familiar to Nd folk who already understand that society is not made for us. Power and structural privilege are key components of colonial ways of being which inevitably filter into the supervision space[4]; which I now understand is oppressive practice.

ND-Affirmative Supervision

Applying a cross-cultural framework can help supervisors understand both the shared and individual experiences of disability. As Olkin notes, most therapy is cross-cultural (able-bodied therapist with a disabled client):

“There are not enough clinicians with disabilities to provide services to clients with disabilities; thus cross-cultural therapy (able-bodied therapist and client with a disability) is the norm.” [5]

A cross-cultural approach would also be useful when managing the stages of the supervision relationship. Being open from the beginning/contracting stage for example about my ADHD feels like an exciting and risky unmasking, but it is clear there needs to be more visibility of Supervisors with disabilities.

Furthermore, as we move into the middle stages of our work, I intend to encourage my Supervisee to explore their fluctuating needs and self care; and how they align/don’t align with their client’s needs. Encouraging cultural humility and curiosity can be helpful at all stages of the work. However, considering the impact of endings when working with Nd Supervisees feels key. Having awareness that some Nd Supervisee’s may experience rejection sensitivity and difficulty with transitions may mean ending the work needs more care. I would manage this through phased endings for example, or encouraging breaks if needed.

The Social Model of Disability (SMD) is helpful when considering what being a Nd-affirmative Supervisor looks like practically. The SMD models the ‘by and for’ approach, as it was developed by disabled individuals who flipped the narrative on disability; declaring that it is society that disables us, not our difference or impairment.

Every day common societal barriers such as physical environment, people’s attitudes, the way people communicate, how institutions and organisations are run, and how society discriminates against those of us who are perceived as ‘different’; can also then manifest as barriers in the Supervision space. This must be avoided, and the first way to do this is through questioning my use of language. Language is very important under the SMD; it is suggested that we use ‘people first’ language as:

“Disabled’ before ‘people’ signifies identification with a collective cultural identity and capitalising the ‘D’ emphasises the term’s political significance. Using the term ‘Disabled people’ or ’Disabled person’ is therefore a political description of the shared, disabling experience that people with impairments face in society.” [6]

This statement also ties in with the social justice principle that the personal is political, and that acknowledging shared experiences is key.

The Nine Areas of Disability-Affirmative Therapy

Encouraging able-bodied and/or neurotypical Supervisees to consider their clients’ disabilities using the nine areas of disability-affirmative framework[7] can help to form a disabled affirmative culture where clients are not whittled down to ‘just’ a label or diagnosis (what Olkin calls ‘the spread effect’). This framework considers the wider picture, history and context of the individual’s disability by encouraging Supervisees to move away from binary thinking (disabled v able-bodied) and consider:

1. current disability status (including pain, fatigue, etc)

2. the developmental history across medical, educational, and disability/illness experiences and beliefs;

3. models of conceptualizing disability;

4. social context and intersectionality of identities;

5. familiarity and affiliation with disability culture and community;

6. experiences and management of discrimination and microaggressions;

7. effects of disability status on friendship and social interactions;

8. emotion regulation

9. disability effects on family, intimate relationships, and sexuality.

Approaching disability in a holistic way can help to promote richer narratives around disability and uses our power differently.

Decolonising disability

It feels important to consider the fact that disability is in fact a colonial construct, as it perpetuates:

“Eurocentric ideals of normative development…that for some Indigenous communities, disability may have historically been a welcome characteristic.” [8]

Discovering new layers of harm caused by colonialism never fails to enrage me. Indigenous approaches to disability are varied but must be considered when imagining a society where ‘another way’ is not allowed space to become a reality.

In pre-colonial Irish/Celtic society for example, each tribe was expected to take responsibility for each member, regardless of ability. Most information from that time is passed on through storytelling and mythology. According to Celtic mythology, physical impairment had different meaning depending on social ranking, so there was a societal and cultural context to how physical differences were viewed. However, ancient Brehon Law ( 7^th and 8^th Century) places heavy emphasis on communal protection for mentally ill and disabled folk. These laws promoted communal responsibility, so exploitation of disabled folk was legislated against.

In Diné/ Navajo culture (people Indigenous to what is now called the Southwestern United States), disability is understood through the framework of care where:

“Interdependence is more than merely mutually dependent, but rather, intricately and infinitely interconnected with the intentions for positive and harmonious outcomes. Care, as a philosophy and practice, is contained in the concept of k’é, and through practice, k’é becomes a lifeway of caretaking.”[9]

These examples suggest that it is possible to form a space that centres community, interdependence and caretaking when considering disability safe spaces. This gives me hope for a different way of doing things. Nd affirmative practices existed for centuries before us, and so that means I am not afraid to say: there is a better way!

Practical Tips for ND-Affirmative Supervision

In my experience, a little goes a long way when creating a Nd affirmative in Supervision. Incorporating even one of the tips below can make a huge difference.

· Breaks Some people with ADHD find it difficult to focus without regular breaks due to a difference in attention regulation. Encouraging breaks is indicating awareness of fluctuating needs. However, certain stimulus helps with focus, which brings me on to....

· Fidget toys These are small handheld tools designed to engage the sense of touch and to expel excess energy. These can reduce stress, anxiety and the need to mask stimming activities (such as pen clicking).

· Environment Consider the sensory (touch, sight noise, taste, smell) feeling of the Supervision space? Can you have fidget toys available? Can you move sessions online if needed? Do you encourage Supervisee to move around?

· Methods of communicating: I believe there is an overreliance on verbal communication in Clinical Supervision. I would like to see the normalisation of symbols, colours, pictures, analogies, dreams and ancestral messaging in mainstream supervision.

· Addressing power dynamics from the outset. Many Nd people value direct and clear communication. However, Pathological Demand Avoidance (a persistent and marked resistance to direct, indirect or implied demands) can be a barrier for Autistic Supervisees. Being overly authoritative can alienate individuals who struggle with direct requests or demands. I might do this by asking a Supervisee “Do you feel there is an expectation to have answers on the spot if I ask you a question about your client?”

· Flexibility If oppression thrives in overly rigid spaces, being as flexible as possible shows anti-oppressive practice. This also shows understanding and empathy for the fluctuating needs of ND folk.

Final Thoughts

Nd-affirmative supervision requires us to be active in dismantling harmful norms, embracing difference, and centring care. It means intentionally using our power to care for ourselves and others. It means building and maintaining supervision spaces that are supportive, flexible, and inclusive — where Nd and neurotypical supervisees and Supervisors, alike can be themselves, and thrive. I am excited for what is to come.

“Caring for myself is not self-indulgence. It is self-preservation, and that is an act of political warfare," -Audre Lorde