Autism Interviews Mental Health Podcasts

Building Your Emotional Toolkit with Autistic Therapist Kathy Carter

On today's episode, I'm talking with guest Kathy Carter, an autistic cognitive behavioral hypnotherapist who works with gender diverse and neurodiverse clients. We will be talking about:
  • the type of hypnotherapy Kathy practices and why it's useful for neurodivergent people
  • what emotional literacy and emotional regulation are and how to improve your own and your family's with some really great practical tips
  •  how to assess whether a medical health provider or a mental health provider is neurodiversity-friendly and neurodiversity affirming.

🎧 Want to listen? This post is based off of Episode 48 of the Neurodiverging Podcast! Listen on Apple Podcasts Google Podcasts | Spotify | Youtube

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Show Notes:

Further Learning:


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Transcript of Building Your Emotional Toolkit with Autistic Therapist Kathy Carter

(Transcribed by the amazing Justice Ross, thank you!)

SULLIVAN: Hello and welcome back to the Neurodiverging podcast! I'm Danielle Sullivan, I am your host, and I am so pleased you're here with us today. Today we have a really exciting guest who shared some really good practical tips for everyday living for neurodivergents, so I hope that you will enjoy. We have our guest Kathy Carter.

Kathy is a cognitive behavioral hypnotherapist in online private practice, with a mostly neurodivergent client base. She specializes in nervous system regulation, especially autistic burnout, identity, and self-esteem. Her practice is Arrive Therapy, which you can find information about in the links below, but it's at arrivetherapy.co.uk, and she offers an international online therapy service.

Kathy also works as a student counselor at a junior school for children with social, emotional, and mental health needs. She is an autistic individual herself, and she's also a neurodiversity advocate and a therapist with the enterprise Thriving Autistic, offering therapy to newly diagnosed autistic adults who have been diagnosed autistic at the Adult Autism practice. These organizations both offer an international online service, but are based in Ireland. At Thriving Autistic, Kathy is supporting autistic adult clients with issues around identity, minority stress, and regulation. You can find out more about those organizations at thrivingautistic.org and AdultAutism.ie, and we will be talking about them momentarily in the interview.

Before we get to that, I just want to thank my patrons for supporting this podcast. The podcast runs on patron donations. If you are interested, please check out patreon.com/Neurodiverging, where you can find out more about how to pledge to the Neurodiverging podcast to keep us running, keep us in business, and to get some very excellent behind-the-scenes perks. So, Neurodiverging - Sorry, you can also find information at neurodiverging.com, obviously, but the Patreon is patreon.com/Neurodiverging.

Today, with our interview with Kathy, we will be talking about the type of hypnotherapy she practices and why it's useful for neurodivergent people; what emotional literacy and emotional regulation are and how to improve your own and your family's, she gave some really great practical tips for doing that; some ways that we can build our own emotional regulation muscles when we're feeling stressed out; and then, on a completely separate tangent, because Kathy is a neurodivergent provider for neurodivergent people, I wanted to talk to her about "How do we assess whether a provider, a medical health provider or a mental health provider, is neurodiversity-friendly and neurodiversity affirming?" So we have a great conversation towards the end of the podcast about how you can make an assessment for yourself as to whether someone you're considering working with is actually neurodiversity affirming, as we want them to be.

So I hope this podcast will be helpful to you, I appreciate you being here today, and, without further ado, here is our interview with Kathy.

Kathy Carter, Autistic Therapist at Arrive Therapy

Alright!

Welcome, Kathy, to the Neurodiverging podcast! I'm so excited you're here. How are you doing today?

CARTER: I'm very good, Danielle, thank you very much for having me.

SULLIVAN: I'm really excited. We were talking a little bit before we hit record, and I was so thrilled to get your message, so thank you for agreeing to be our guest. Could we just get started by, can you tell the listeners a little bit about yourself?

CARTER: Yeah! Sure. So you can probably tell I'm from the UK. I am an online therapist with mainly neurodivergent clients. I work with the social enterprise Thriving Autistic; we're based in Ireland. And they, in turn, work with the Adult Autism practice. So myself and my peers there, my fellow therapists, we work with a lot of newly diagnosed adult autistic people.

So I'm also in private practice in hypnotherapy. My therapy provider is Arrive Therapy. I'm a student counselor at a school, as well, so I work with junior-age children, which is up to age 11 over here. Again, most of them are neurodivergent. And I'm also a neurodiversity advocate, I would say. So I work a little bit for the trade press over here, the therapy press. And I'm autistic. I have a son who's autistic and has ADHD. And I was diagnosed autistic when he was 4, so perhaps a little similar to your journey.

SULLIVAN: Very much so, yeah.

CARTER: Late-diagnosed. Yeah.

SULLIVAN: Thanks so much! Yeah, my son was diagnosed at, I want to say 2 and a half, and, yeah, I was diagnosed right after. And also, I don't know if you've met Carole Jean Whittington, who has been a previous guest and works with Autastic, but, also diagnosed after a child was diagnosed; I think it's very common, isn't it? So.

CARTER: Yeah. I think it is, I find... In fact, a large number of my adult women clients, I would say, have gone through that journey. It is very, very common at the moment.

SULLIVAN: Yeah. Yeah, it's really interesting. I also, in the coaching clients I work with, find that it's mostly women who have been identified after a child has been identified, usually either ADHD or autistic. So, yeah.

CARTER: Yeah.

SULLIVAN: We're definitely missed over a lot!

CARTER: Yeah.

How does cognitive behavioral therapy work for autistic people?

SULLIVAN: But I'm really glad you're here, and I'm excited to talk to you. So I know you're a hypnotherapist, and I don't know anything about hypnotherapy except what I Googled frantically before speaking with you, and I'm sure I've got it very wrong. So would you be able to tell us a little bit more about the type of hypnotherapy you practice and how it works for neurodivergent people specifically, if you can?

CARTER: Yeah, sure! So I feel like I'm quite sort of hybrid, in the sort of service that I offer. So I would say I'm a holistic hypnotherapist. So I work online, and my modality is actually cognitive behavioral hypnotherapy, which, as you might imagine, is a combination of CBT and hypnosis. And that's looking at how we use our thoughts and our behaviors in our day-to-day lives. I'm also quite interested in trauma-informed therapies, like dialectical behavioral therapy and things like the polyvagal theory of the nervous system. And I find that CBT-type work isn't always that suited to neurodivergent individuals -

SULLIVAN: Yeah.

CARTER - so I can talk a bit about that if you'd like me to. But really, my hypnotherapy is about a lot of regulation. You know, sometimes with clients we might not really do any "pure hypnotherapy," if you like, but a lot of the times, we will, we'll be doing regulatory work, relaxation, mindfulness, or we might embed a little behavior somehow using it. So very hybrid, I think, and, yeah, a little different to what many therapists would offer.

SULLIVAN: I have the level of CBT awareness that many coaches have, but obviously am not a medical professional or a mental health professional. I have heard, I guess, and I guess I have seen, that CBT isn't always a good fit for neurodivergent folks, but that dialectical behavioral therapy and some other modalities are better options. From your experience in the kind of therapy work you do, has that held true, and do you have any sense of perhaps why CBT isn't always the best fit?

CARTER: Yeah, I do. I mean, I had CBT myself. I suspect at that time I didn't know I was autistic. I found it really great; it was a good fit for me. But typically, I would say a lot of the time with CBT you're trying to introduce cognitive flexibility.

SULLIVAN: Mm-hm.

CARTER: And we're quite inflexible.

SULLIVAN: (Laughs)

CARTER: And that's ok.

SULLIVAN: Yes.

CARTER: And that's ok! That's part of who we are, isn't it? And I wouldn't want to change a client who was presenting in an inflexible way, because it serves them a lot of the time. It can focus on safety-seeking, you know, you might be avoiding some social event or something. You know, autistic folk have a lot of social anxiety, and again, there's some safety seeking behaviors which are just intrinsic and ok. And, you know, I wouldn't want to change those. Mainly, for me, I don't feel that CBT as a therapy really aligns as well as I'd like with nervous system regulation. And if you've got a client with, as, you know, if we're just doing the work on ourselves, if we're quite dysregulated, so if we're in shutdown, if our system is very kind of slow, and flat, and we're very challenged...

SULLIVAN: Mm-hm.

CARTER: The cognitive stuff, all that meta-cognition, all that processing, looking at our beliefs... We can't access that, you know, we just need to get through the day a lot of the time.

SULLIVAN: Mm-hm.

CARTER: So, you know, you might have a client in that state, and all they need is regulation, relaxation, really basic stuff. You know, the cognitive work, I think, comes when you're a lot more regulated. So I believe it's very useful, dependent on your state and, yeah, how you're feeling on the day.

SULLIVAN: Yeah, but it's maybe not step 1 in all the work you have to do, sometimes, to feel more ok in your day-to-day life.

CARTER: Yeah! Yeah, I suppose it's... it is a journey. So, you know, once you get into some very simple little CBT techniques, they can be almost second nature, and you use them just day-to-day. But it's, yeah, it's something that isn't the first base, as you say. I think it's, you know, certainly with clients I would be trying to work out what's going on for them, how regulated they are. You start to look a little bit about beliefs and "should"s and all of the stuff that autistic folk have to deal with in terms of marginalization and everything. You know, how is that affecting their view of the world?

SULLIVAN: Mm-hm.

CARTER: But yeah, I do use it and I'm a fan, but I would urge a little bit of caution with CBT, yes.

SULLIVAN: Yeah, yeah. I also have experience personally, as a client, with CBT, and it was very helpful for me.

CARTER: Yeah!

SULLIVAN: But I also have bumped into, many times, places where it's just not a good fit. And as you say, I don't want to be pushing clients who are highly stressed and highly dysregulated into, you know... Like you said, I think it's a really good point that we can't always access our feelings or our thoughts to alter them with cognitive behavioral therapy when we're that [rigid]... You know, rigidity comes with stress. So the more stressed out we are, the harder it is to access that stuff, so I think that's a really good point. Thank you.

Why do autistic people struggle to identify and regulate emotions?

So you talked a lot right there about emotional regulation and sensory... you didn't say "sensory," but polyvagal systems getting aligned, getting coordinated in your body. Do you have a sense of why so many people, especially autistics, have so much trouble identifying emotion and regulating emotions in their day-to-day life?

CARTER: You know, I think it's a combination, isn't it. So many things, obviously the executive function difficulties, the sensory stuff, you know, obviously big challenges.

SULLIVAN: Yeah.

CARTER: And I think we, just as humans, as the population, we aren't terribly in touch with our nervous systems. So, you know, you've got alexithymia, obviously, when we can't quite connect with that feeling, but also, I think autistic folk have trouble processing our emotions in the moment. So if someone says "How are you feeling," you know, we probably know very well or can access at some point how we're feeling, we'll work it out—but in the moment, it's very hard just to say, oh, "I'm sad," "I'm happy," or whatever. And, you know, that's part of our neurology a lot of the time.

I think, as I alluded to, you've got the oppression and the marginalization and that brings anxiety, doesn't it? Minority stress. That leaves us a bit disconnected.

And I think we're not very in touch with our nervous systems. So I've, I guess, developed quite a good sense now of what state I'm in. But for example, you know, you can be up in the fight or flight response or down in the shutdown freeze response, and in each little response, really, there's a state. And in that state, our bodies experience different things, different sensations, and the thoughts are very different as well. So, you know, we're just not always sure what state we're in. And of course, children don't get taught all of this stuff at school, [children] of any neurotype. In most children, it's not there, is it, Danielle? It's just not taught unless the parents are able to help their children regulate.

SULLIVAN: Mm-hm.

CARTER: So yeah, I think we're just not used to regulating, and yet people expect us to all the time. So I think it's about personal growth, personal development, and just getting to know yourself, really.

SULLIVAN: Mm-hm. Yeah.

CARTER: Yeah.

Social-Emotional Learning for Children at School

SULLIVAN: So, I'm an unschooler, I have my kiddos at home with me now. But when they were in traditional, conventional school systems in Colorado: Colorado has a really, for the United States from what I can tell, a relatively robust social-emotional learning program for preschoolers and on up, where they are, to some degree, helping kiddos identify their emotions, talk about their emotions, and then communicate about them to others.

And it's great, and I'm glad it exists, but even that is so little compared to what I feel like many neurodivergent kiddos need, especially my neurodivergent children who are autistic and ADHD. We do so much work daily on just, "How are you feeling," you know? What is that like in your body? And then sort of finding that on a scale of, "You feel like this is big, is this really big?" Right? Or, "You feel like this is a small problem, is it really a small problem?" Just sort of... contextualizing, I guess, is the best way to say that.

But I know many other places don't have any kind of social-emotional learning in school systems, and I don't know how it is in Britain, or if it's more cohesive than the United States is. Because schooling in the United States is very, very depending on where you are.

CARTER: Yeah, I'm not really sure I can answer that, because my experience is, I guess, fairly limited. But I've found, based on the school I work at, and my son's school, and my clients' schools, that it's very dependent on the staff.

SULLIVAN: Yeah.

CARTER: So if you have usually a head teacher who is very focused on social, emotional, and mental health needs, as my school is where I work as a student counselor, the children are so lucky, you know. They've got the sensory room, they have a student counselor at the school as well as other counselors, every classroom name is named after a positive value; it's intrinsic, it's built in.

SULLIVAN: That's wonderful.

CARTER: But I do know that lots of schools aren't that fortunate, for whatever reason. So I feel it's a bit dependent on the staff actually and, you know, the support they've got access to.

SULLIVAN: Yeah. So maybe similar to the United States at least a little bit, in that one specific sense, yeah.

CARTER: Yeah.

What exercises can support emotional intelligence and literacy?

SULLIVAN: Can we go back to emotional literacy a little bit?

CARTER: Mm-hm.

SULLIVAN: We talked about why it's hard for adults. It's hard for adults—to really, really sum up very briefly what you said, because you said it much better, but—adults have trouble regulating because we don't get enough practice in childhood, at least to some degree, right? And we have trouble identifying for the same reason, we don't get enough practice, and it's not highlighted enough in our day-to-day.

For folks who are working on their emotional literacy—understanding their feelings, regulating their feelings—as adults, are there go-to ways that we can build some of those muscles up? Or... Obviously, it's very individual, but are there some exercises or some ideas that you might have for sort of the general population, to help that?

CARTER: Yeah, so. Certainly, with the young people I work with, I do always encourage them to develop a sort of emotional toolkit. You know, so we talk about values, and strengths, and so on, and how to calm down and regulate with things like music or discharging with sensory toys.

But I do have a little exercise that I use a lot with my clients, which I developed from DBT but uses the acronym RED, R-E-D. And I would say, if people kind of practice this day to day— It's for use when you are heightened, really, hence "seeing red."

So the R would be to Regulate. So in that moment, you know, you're triggered, you're heightened, maybe you've gone into fight or flight. Something's happening in your body, you're getting those sensations. Do something to regulate, whether that's a relaxation technique, breathing technique, a lovely one is just to breathe in and hold for maybe 6 counts, breathe out slowly, and just do that 2 or 3 times. The parasympathetic nervous system kicks in.

SULLIVAN: Yeah.

CARTER: And that's just—just in that moment, and it takes seconds—just the first thing to do.

E is for Evaluate. So, work out what's happening. Is your body indeed under threat as it perhaps thinks it is? Can you respond rather than react? What's happened to my nervous system? You know? What's happening, is my heart beating faster? You know, evaluate what's happening in your body—and your surroundings. Think about what you can see, what you can hear, what you can sense, and try to bring the attention back more internally, with the breath again.

And then the D is Do something. So this is where you grab your toolbox, you grab your skills. You could suck something very sour, you know, and you can have a little pack in your purse or your bag of these useful things, some of those Tangfastic sweets, you know, the Haribo ones. Something really that makes you... you know, makes your face suck up.

SULLIVAN: Pucker face, yes! (Laughs)

CARTER: They are great for distraction. Something cold; you could travel with a bottle of cold water and just tip some of that on your wrists or hold it on your temples, or, if you're indoors, go grab an ice cube or something, hold it on your wrists or your temples. Listen to a music track. I like a sort of punk rock if I'm feeling quite heightened, so I would use that to regulate.

You could use a cognitive technique like counting backwards from 100, maybe, that's a very good distraction. Affirmations, "I'm in control of my mind and body" is a lovely one. You could visualize a safe place, which is something we do in hypnotherapy quite a lot ahead of needing to do it when you're heightened. And you can tap the collarbone, you know, these sort of emotional freedom technique-type tapping. You could use a havening, when you're sort of stroking the top of the arms.

And all of that can take minutes or seconds. And if you're practicing it at the traffic lights, or when the kettle boils... It's a really good little tool in that heightened moment when someone's cut you off in traffic, or your child has triggered you, or you've triggered your child, just to remember, "Oh, ok, RED: Regulate, Evaluate, Do something."

I do a lot along the film Inside Out, you know, with that lovely panel of collaborative characters. So I always talk, especially to the young people, about their version of that, and what are their parts, what are their configurations, and often we'll give them names. And the child, obviously, thinks of the name, or draws them even. So that is really good, I think, for emotional regulation, to go "Oh, ok, it's my Squigglyfluff," is one of the names that I love.

SULLIVAN: That's adorable.

CARTER: "My Squigglyfluff is—" I know, isn't it lovely? "It's driving my train at the moment, it's driving my body, it's in control. And you know, I'm actually in charge here, so thanks, Squigglyfluff, let's just calm everything down," and, you know, just think about that control panel in the brain and who's in charge. And essentially, the individual has to be in charge, not a little part that's being triggered. And there's obviously stuff around, you know, boundaries and self-care. All of the usual things that we just need to do to be healthy humans, essentially.

SULLIVAN: Yeah, but that was a fantastic list of kind of red-alert, immediate response. I especially appreciate... I think my tendency, personally, is to go for the cognitive distract-my-brain piece. But I certainly have clients [who are], and my kiddos are, much more sensory, distract sensorily. So the ice, you know, those kinds of... the sour is a great— I've never done that, and now I'm like, "Oh, I've got to try that, next time one of my children specifically has that kind of overwhelm feeling." I'm like, that will work really well, and I've never considered it! So thank you so much.

CARTER: Yeah!

SULLIVAN: I'm sure that lots of listeners are like, "Aw, that's a great list!" So, yeah.

CARTER: Often you're distracting your brain, aren't you? In that moment, you just need to give it something else to think about.

SULLIVAN: Mm-hm.

CARTER: Because obviously, overwhelm can lead to panic, can't it?

SULLIVAN: Yes.

CARTER: You know, that there's a moment in between the sensory input, your reaction to it, and then what happens next.

SULLIVAN: Yes.

CARTER: So if there's any way to slow down the process and react a little more carefully and slowly, it might reduce the meltdown, it might stop the meltdown, or it might stop some kind of self-injurious behavior. It might just mean you take less time to regulate back up and to recover. So, yeah, I think— and people will find their own little tools.

SULLIVAN: Yeah.

CARTER: You know, there's lovely things like weighted blankets, and olfactory things, smelling a certain scent is really nice sometimes. And that's often—not the blanket, but, you know—the roller-ball scents, you can have that in a purse, can't you? And, yeah, just develop a toolkit.

The Nervous System as A Traffic Light

SULLIVAN: Yeah. That's really helpful, thank you so much. I really appreciate that. Do you have any other thoughts or ideas about the nervous system and regulation that folks can kind of take home and use? Like, the RED system is so... I love how direct it is, and how you can just grab it in a moment of crisis and it's very short and sweet.

CARTER: There's a sort of concept that I really just used with myself initially, but I find it really useful for clients of all ages—and all neurotypes, actually, so this isn't exclusive to neurodivergent clients. But I see the nervous system as a traffic light, essentially. So you've got red, amber, and green. And this little theory, I suppose, ties in with polyvagal theory, it massively ties in with attachment, which I know you're passionate about as well, Danielle.

SULLIVAN: Yes.

CARTER: And lots of other theories, along the hierarchy of needs, and even energy centers in the body. There's so many things that I think this is a fit for. But I really see the autonomic nervous system as a sort of three-tiered ladder, is another way to look at it. So at the top, in the green, is our very connected, quite securely attached, very up, energized, safe place. That's the important word; it's a safe place. And for many autistic folk, we do struggle to stay up there. You know, we're often dysregulated, we're triggered by sensory stuff, it is quite hard to stay up there. But when we're there, we feel good, the inner critic isn't there on our shoulder. We're just safely connecting to people, animals, the world around us.

Underneath that in the traffic light system would be amber. And for me, amber is my warning sign. I sort of know that if I overdo it when I'm in amber, red zone might follow, and that's a little trickier to deal with. So amber is also quite productive, but it's your fight or flight, so it's heightened. It's a bit anxious, basically. And it's when we might fire into anger, when we might fire up into indignation, very triggered easily, lots of anxiety-based responses. It feels, to me, when I'm like that—as I am, I would say, most of the time—a fast existence, my head feels fast.

SULLIVAN: Yeah.

CARTER: And the red zone is for shutdown or, indeed, the freeze response. And for me, that's where you would find burnout and shutdown. I think a meltdown would probably occur higher up; you know, that's the heightened stage, and then you crash into red.

SULLIVAN: Mm-hm.

CARTER: And that's recovery. You know, they're all normal and natural, and we dip in and out of them. Or, we should dip in and out of them; I think neurodivergent folk get stuck a little bit. But yeah, when you're down there, that's a little dangerous really. That's where we can find more self-injurious behaviors, less self-care. That's when all of the self-talk is quite negative. You're feeling flat, you're feeling tired, you've got a low mood.

And like I alluded to earlier, if you can ascertain which state you're in, I find it very useful, but you need to be quite accepting as well. So, not to fear the red state, not to be cross with yourself when you're in it, just to accept that today is a red day, I need self-care, I'm gonna have low demands. I'm really gonna look after myself, and nurture myself, and sit with what comes up, and be very compassionate towards it, knowing I will get out of it. It's a state; we can get out of it. And there are ways to get out of it with safe connection to people or animals, walks in nature, regulatory tools, like, again, with the music and whatever works for you.

Yeah, the little analogy of the traffic light feels quite easy for people to understand, and especially young people as well.

SULLIVAN: Yeah. That's a really great tool. And I can see it being used... I had so many thoughts while you were speaking. I can see it being used in families, especially, because one concern I get from a lot of coaching clients who are parents is that they get overwhelmed and their child still has needs, and they're not sure how to navigate that. And so part of what I always recommend is, you know, talking with your kiddo and setting some vocabulary that's the same across [both of you]. So if you both take breaks. Whatever your strategies are, you both have access to them at all times. And so that way, the child is more likely to understand when the parent is in red or amber. But I had not gotten to the point in my own thought process of putting it into a physical object like a traffic light, and that is beautiful. And I can imagine that many people get a lot of value out of that. So thank you so much for sharing it.

CARTER: It's ok.

SULLIVAN: Yeah, I really appreciate it.

How can patients find neurodiversity-friendly health providers?

The other thing I wanted to talk to you about today is a completely separate topic. But when we were originally talking together, I know that you do some training for other mental health providers and other folks on how to be more neurodiversity-affirming in their practice and how to bring human rights work and autistic rights into their mindset when they're working with neurodivergent clients and people.

Do you have any advice for autistic or neurodivergent individuals who are looking for neurodiversity-affirming providers? Because, at least in the US, there's not great ways to assess that. You can ask individual providers if they're neurodiversity-affirming, but sometimes they'll say yes but really not have the training that supports that. And I've had many emails and questions from podcast listeners and coaching clients who have reported just, unfortunately really sad negative experiences with providers who are meant to be neurodiversity affirming and [are] not. So how do we, as clients, assess whether somebody actually is neurodiversity-affirming in their practice and their concept of treatment, versus just kind of saying it because it's the best word? Do you have any thoughts?

CARTER: Yeah, I think likewise, it's the same for us. I feel things are improving, but it's still very challenging.

So first off, I would look for the language that the provider is using. I personally like identity-first language, so, "I am autistic" rather than "I have autism." That's not universal, but for me, that's something I would look for.

I find the puzzle piece quite dated and off-putting.

SULLIVAN: (Laughs) Yes, I agree.

CARTER: So if a website was emblazoned with that, I would find it a little alarming.

Very medicalized language, which I know is a hard one to overcome, because, you know, depending on who's funding the provision, you know... Obviously, we're talking diagnosis here, it is medicalized. But again, if it's too much. I would want to see some of the social model coming into their advertising materials, their social media, and so on.

And I would look for neurodivergent people working there, on the board, you know, if it's charity or some bigger provider.

SULLIVAN: Yes.

CARTER: And that's obviously an asset they'll promote, so most organizations like yourself or like myself, we'll mention it, because we know it's a way of connecting with clients.

I would avoid any coercive training-type provisions that try to take away a client's autonomy; you can spot them, I think, quite easily.

If it's a provider, you know, an individual, you can go onto their website and look out for very neurodiversity language, they might flag it up on their listing.

I personally—and this is a bit of my opinion—I find it off-putting when an individual or service provider knocks labels. So I know it's quite cool to not have a label. So you'll hear things like "Autism doesn't define you," or, you know, "You're many other things other than your autism," as if we could take it on and off. But certainly over here, and I'm sure in many autistic communities, the label is part of our identity, our tribe, our kinship. So just as being gay or genderfluid, gender-diverse, is a community and an identity, for me and a lot of my clients, being autistic is like that too. I've had multiple therapists use quite non-affirming language with me, and say "You don't look autistic," and things like that. That's a red flag.

SULLIVAN: Ah.

CARTER: I mentioned at the start that I work with Thriving Autistic. This is a social enterprise that lists a lot of neurodivergent therapists in all sectors, from counselors and hypnotherapists to occupational therapists, and most of them work internationally online. ThrivingAutistic.org has a list of therapists there, which your listeners may well be able to utilize. Over here, we've got the Association [of] Neurodivergent Therapists, which is another nonprofit that has therapists working out of the UK island, and again, a lot of those may well work online. They're at NeurodivergentTherapists.com.

And I suppose mainly I would just try and speak to the provider. Trust your instinct, ask them questions, you know. Find out what training they've got, find out who is there who is autistic or neurodivergent, and just see what your gut tells you, really. I think that's... There's a lot to be said for trusting your instinct.

SULLIVAN: Yeah. Thank you. I appreciate how you elucidate some of the problems with the language, the puzzle piece, the way autism is framed as an identity or is not framed as an integral part of who we are sometimes. That is a piece that, you know, I can gut-check and say "That doesn't feel right," but I had not actually gotten to the point in my own thinking of getting the link between how disassociating ourselves from our identities is actually, like... For a provider to do that does link to potential harm in the future. So I really appreciate that.

CARTER: I think it's widespread across education, social work, psychotherapy, counseling, just everywhere. And there's a lot of changes around equality and equity and, you know, disability awareness and acceptance, but it does come in small steps. So I suppose, if we're able to flag it up, we can do so, can't we, in quite a kind and helpful way if we find therapists or providers. I've done it recently, actually. There's a local authority who gave a presentation at my son's school, and I quite, I hope helpfully, suggested to them some changes to their website, because some of the language was a little dated and so on. And I think we can all do that. If we see it, we say it, you know? We flag it up. Because that's how we all learn, isn't it?

SULLIVAN: Yes, exactly. And approaching kind of kindly, and curiously, and helpfully, a lot of folks respond very well to. And many people are trying their best to be supportive, and just don't have the resources or the access to the kind of education that's most up to date.

CARTER: Yeah.

SULLIVAN: So I appreciate you saying that.

CARTER: Yeah.

SULLIVAN: Wonderful, thank you. So the links that you mentioned, just for listeners, will be in the show notes and also linked below, so please go check that out at ThrivingAutistic.org and AdultAutism.ie. And I will also be linking Kathy's website, at ArriveTherapy.co.uk. And you offer, right, international online therapy, so folks can access you potentially from worldwide?

CARTER: Yeah, that's right. It's so easy now, isn't it, with all of our technology?

SULLIVAN: I love it.

CARTER: Yeah.

SULLIVAN: It has made this podcast and many other things possible, so I am very grateful for it.

CARTER: Yes. Hop onto ArriveTherapy.co.uk and I've got some podcasts there, I've got some blogs there, some content. Yeah, everything is there.

SULLIVAN: I was on the website last night, and there's some really blog material especially. Maybe I just focus on the reading because that's my brain -

CARTER: Yeah.

SULLIVAN - but I liked your post on the polyvagal theory and how it connects to neurodiversity affirming. And there's some really good stuff, so I encourage people to go check it out; links below. Thank you so much for being here today, Kathy, I really appreciate it. I think people will get a lot from this interview.

CARTER: Oh, well thank you, Danielle. It's been such a pleasure; I've really enjoyed it.

[Music]

Contact Danielle Sullivan

SULLIVAN: Thank you so much for joining us on the Neurodiverging podcast today. I really appreciated Kathy's description of some of her systems that she uses to help people in emotional distress, like the RED system and the traffic light system; I hope that they will be useful for you. I really encourage you to go find out more about Kathy and perhaps see if she might be a good fit for you. Check out the links below and in the show notes, and also, we have a transcript available for folks who would like it. I am available, if you have comments or ideas, at neurodiverging.podcast@gmail.com, and I look forward to seeing you again in the next podcast.

Please remember, we are all in this together.

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