Personalised Strategies in a Standardised World

As both a psychotherapist and an autistic person, I've found myself uniquely positioned to observe and reflect upon the complex interplay between societal expectations, professional practices, and the lived experiences of autistic adults. Through my work and personal journey, I've come to wonder, “how do  we conceptualize and discuss "functioning" within the context of autism and neurodiversity?”.

The Problematic Nature of "Functioning" Labels.

The term "functioning" has long been a staple in discussions about autism. However, as our understanding of neurodiversity has evolved, so too must our language and conceptual frameworks. The traditional high-functioning/low-functioning dichotomy, while seemingly straightforward, fails to capture the nuanced and dynamic nature of autistic experiences.

As a therapist, I've observed how these labels can inadvertently pigeonhole people, leading to misconceptions and potentially harmful interventions. For instance, a client conceptualised as "high-functioning" might not realise that there can be supports that are quite necessary for them. Other people wouldn’t see their need, either, and the person themselves would easily sum-up that they can "manage" without assistance. Conversely, someone deemed "low-functioning" might have their capabilities underestimated, leading to reduced opportunities for growth and independence.

From my personal experience, I can attest to the fluctuating nature of what might be termed "functioning." There are days when I can seamlessly navigate complex social situations and professional demands, while on others, basic tasks can feel overwhelmingly challenging. This variability is not a reflection of changing abilities, but rather of the complex interplay between internal states, environmental factors, and societal demands.

The Influence of Societal Expectations.

I can’t really discuss functioning without acknowledging the profound influence of societal expectations and capitalist structures on our understanding of what it means to function "well." As both a practitioner and an autistic individual, I've witnessed firsthand how these expectations can create undue pressure and feelings of inadequacy.

The prevailing narrative often equates good functioning with productivity, social conformity, and adherence to neurotypical norms. This narrow definition fails to account for the diverse ways in which autistic people might contribute to society and find personal fulfillment. Moreover, it can result in the absorption of these societal expectations, giving rise to 'internalised ableism' - a form of self-directed prejudice stemming from the belief that disability is something to be ashamed of, hidden from view, or a reason to reject assistance or accommodations.

Personalised Strategies for Wellbeing

One of the most important lessons I've learned, both through my professional work and personal experience, is the critical importance of personalised strategies for wellbeing. The neurodiversity paradigm teaches us that there is no one-size-fits-all approach to being autistic or any other neurodivergent set of realities. 

For instance, I've found that some clients have identified that their wellbeing is best supported by a work schedule that allows for intense periods of focus interspersed with longer breaks. Others have been able to arrange most of their week working from home.

Similarly, I've worked with autistic people who have found success in unconventional lifestyle arrangements. A  colleague of mine,  for example, thrives with a job that allows them to work intensively for several months followed by extended periods of rest and recovery. Another has found that living in a small, close-knit intentional community provides the perfect balance of social interaction and solitude.

As I reflect on these complex issues, I'm acutely aware that we're still in the early stages of truly understanding and accommodating neurodiversity in our society. The path forward isn't simple or straightforward. It requires ongoing dialogue, research, and a willingness to challenge deeply ingrained societal norms and professional practices. 

As a psychotherapist there sometimes comes a time in therapy-room conversations where an examination of  concepts like "functioning" crop up. Exploring options and viability around personalised schedules and processes, and considering ways to advocate for those, can be very rewarding. 

Author: Vauna Beauvais. Contact me here.

You can see the rest of my Vauna Beauvais psychotherapy practice blog posts here, and if you’d like to listen to a YouTube podcast of myself and a fellow therapist talking about functioning here and you might want to watch my new (and growing) video series on neuroaffirming therapy here.