identity and diagnosis
A lot of people come to therapy uncertain about how to describe themselves. Is it acceptable to say you're autistic, dyspraxic, or have ADHD, if you haven't had an official medical diagnosis? Since it's more difficult than ever to be referred for assessment, people can get stuck for months and years, putting their wellbeing on hold until they know for certain what to call their experience.
Other clients, when they come to therapy, are clear that they do not wish to be labelled. They may have had bad experiences already of being stereotyped and profiled, and want therapy to be a place where they can explore all the different and contradcitory parts of themselves without prejudice. Paradoxically, the push in progressive societies to acknowledge fluidity and diversity in terms of gender expression, sexuality and neurotype, can also generate pressure to be certain of our identities in ever greater specificity. This can be stressful for people of an analytical turn of mind, who may struggle to put words to their physical and emotional experience and fear getting their identity 'wrong', and who might also be confused about who they really are after a lifetime of code-switching and masking.
Ultimately, we are complex beings, operating in a number of different frameworks. We are members of social groups, products of our place and time, survivors of our own histories, and animals with bodies and brains and nervous systems. It is impossible to find a label that will capture each of us in all our complexity. But if you are considering whether to seek a diagnosis, and wondering how to understand and define yourself in terms of neurotype, here are some things to consider:
For adults, the diagnosis of ASD and ADHD is descriptive. This means that diagnosis is made on the basis of your self-reported experiences, and the observations of people who knew you in childhood.
What might an official diagnosis give you that you don't have at the moment? Access to more support at work or in education? Medication for ADHD symptoms? Permission to live your life in ways that suit you better? Recognition from loved ones? Self-acceptance? A sense of belonging to a community? (If you are reading this and have a child in school, remember that in the UK you do not need a diagnosis to apply for an EHCP)
What, if anything, worries you about the idea of seeking diagnosis? Do you feel like you might just be 'making it up' or 'making excuses'? In not seeking a diagnosis, are you preventing yourself from accessing help, or obtaining reasonable adjustments at work or education?
What, if anything, worries you about the idea of getting a diagnosis? Are you concerned it would change you, or change the way people see you? Remember that you are under no obligation to disclose a diagnosis to anyone.
Can you imagine how you might feel if after assessment you did not receive the diagnosis you expected? Relieved, confused, upset, ashamed? What might you do next? How would you look after yourself?
What would you give yourself permission to do differently if you had a diagnosis? How might you prioritise differently? What systems could you put in place to make life more user-friendly? Could you do those things now?
What conversations might you have with family and friends if you received a diagnosis? Is there anything you'd like to talk to them about, or to ask them? If so, could you imagine having those conversations now?
You don't need a diagnosis to start making changes to your environment and life routines that would suit you better, remove stress, and make you happier and more energetic.
Support communities for autism and ADHD wholeheartedly welcome the self-diagnosed, for a number of reasons: because it can be a long and difficult process to obtain diagnosis via the NHS, because many people don't see the need for a diagnosis when their neurodivergence feels very clear to them, and because many feel that medical diagnosis pathologises naturally occurring cognitive variation.
If you are want to engage in a community or simply hear the experiences of other neurodivergent adults, search on Facebook, Reddit and Mighty Networks for groups and communities that sound like a good fit for you.
For more resources on Autism, ADHD, and Dyspraxia, see the websites below:
