Divide to Unite?
A new client emailed me last year, possibly drawn in by my website copy, which makes it pretty clear that in addition to my master’s-level education as a social worker, I have a generous amount of real-life experience with autism. Tacked onto the inquiry about therapy were questions about my views of neurodivergent people, theories of autism, and my opinion of ABA.
I knew I would lose this client.
It’s my job to meet clients where they are. Whether they describe themselves as autistic, a person with autism, an Aspie, or neurodivergent, it’s up to me to respect their preferences and make them feel comfortable working with me. With any client, my opinions are generally left at the door. Clients don’t often want to know what they are.
This one did, though, and I knew that the answers the client was looking for probably were not the ones I would give. But beginning a therapeutic relationship with a lie was unethical as well, so I obliged with an overview of my beliefs about autism, which can be summed up as follows:
That neurodiverse individuals have unique views of the world and are as entitled to respect and understanding as anyone else.
That my daughter with autism is loved as much as her neurotypical sisters.
That autism often presents with comorbid medical conditions that, when treated, improve quality of life.
That any interventions for my daughter are chosen to help her grow in health, happiness, and independence.
While it may not be true for everyone, for my daughter, autism is a disabling condition.
That I usually use person-first language. (As her parent, I have often found it’s important to remind people that my daughter is a person, not a label.)
I never heard from the client again. I suspect the last two points were the nails in the coffin, but I’ll never know for sure.
The autism community in 2021? Still fractured.
Oddly, I’ve been wondering whether one of the best ways to heal the fractures — or at least tone down the rancor — is to further divide the community with subtyping.
The American Psychiatric Association got rid of a subtype when they eliminated Asperger’s Syndrome from the DSM-5. I miss it; I thought it was an effective descriptor of the mild end of the spectrum. I wish researchers would go further, by thoroughly investigating all the manifestations of autism. What can we learn from the child who showed symptoms from birth, versus the one who regressed at age 2? Why does autism interfere with some people’s ability to speak, and not others?
Would subtypes make it easier to understand all the ways autism comes to be, and how it’s experienced by those who have it? I wonder if highlighting differences might actually promote understanding that one person’s autism is very different from another’s.
At the very least, I would love not to choose between telling my truth and keeping a client I believe I can help.
