Being Neurodiverse in a Neurotypical World

Cindy Lopez: Welcome. My name is Cindy Lopez, the host of this CHC podcast, Voices of Compassion. We hope you find a little courage, feel connected and experience compassion every time you listen.

Join us for this podcast episode as we explore the experience of neurodivergent individuals navigating a world designed for neurotypical minds. In this conversation with CHC experts, Dr. Melanie Hsu, clinical director and licensed psychologist, Dr. Marjan Ebadi, we talk about challenging the traditional deficit model that focuses on fixing neurodivergent traits instead of embracing a strengths-based approach that celebrates the unique abilities and perspectives that neurodiversity brings.

We also discussed the emotional toll of masking, which is the exhausting practice of hiding natural behaviors to fit in and share insights on recognizing when loved ones might be suppressing their authentic selves. Join us for this important conversation about building a more inclusive world that values all types of minds. 

Welcome, Dr. Hsu and Dr. Ebadi, I know that our listeners would love to hear a little bit more about both of you, so why don’t you take a minute to introduce yourselves.

Marjan Ebadi, PhD: Hi, I am Dr. Marjan Ebadi. I’m a psychologist at CHC, and I provide mostly psychological evaluation for ADHD, learning disability, and mood disorders. Happy to be here.

Melanie Hsu, PhD: And I am Dr. Melanie Hsu. I’m also a clinical psychologist. I’m also our evaluation program manager at CHC, and also the clinical director of our Medi-Cal clinic. And I also primarily do evaluations, and my specialty is neurodiversity and autism.

Cindy Lopez: Nice. Well, we’re so glad that both of you are able to join us today for this conversation about neurodiversity. So let’s start there. For all of our listeners, how do you define neurodiversity?

Marjan Ebadi, PhD: So, neurodiversity, it’s a term to describe how our brains are working. Everyone has like a unique type of brain and we develop in different type of ways. And for this specifically when we use neurodiversity is to explain unique challenges and strengths that people could have throughout their life. It’s lifelong of how your brain works.

Melanie Hsu, PhD: Building off of what Dr. Ebadi was saying, it’s definitely just the way that people are along a spectrum. So, there are benefits of being neurodiverse, and then there are things that make things a little bit more difficult, but you just see the world and experience the world in slightly different ways than the majority of people do.

Cindy Lopez: Aren’t we all neurodiverse then, based on what you just said? I mean, it seems like all of our brains are a little bit different from each other. Is that true?

Melanie Hsu, PhD: Neurodiversity is a very broad term, and so what we do want to emphasize is that neurodiversity in and of itself doesn’t mean psychopathology. So, we talk about how there are many ways of being, there are many ways of experiencing life, and then there are some times when things make it a little bit harder. And so when things are harder, that is when we start talking as clinical psychologists about clinical disorders or those kinds of things. But in general, neurodiversity is more broad than just something you would go see a psychologist for.

Cindy Lopez: And when we talk about neurodiversity, I think a lot of us, and perhaps some of our listeners, we probably think that there are some negative connotations to that. So, there is stigma associated with neurodiversity, so talk about that for a minute.

Marjan Ebadi, PhD: For stigma, I think when we are thinking about, again, going on a clinical level of things when we call like stigma for neurodiversity, most often we’re referring to kids who have ADHD, autism, or sensory processing and then before they get a diagnosis, what it looks like is low-motivation, or they’re just lazy, or they’re not trying hard enough or they just want to get accommodations, that’s why they’re acting this way. So, I think there is a lot of things we hear before kids come in for testing or just wanting to see how they can get the help they need. And most often, I think the other term that’s been used is, always a new trend, like everyone’s trying to fit that mold.

Melanie Hsu, PhD: Yeah, and I think part of it is also there are a lot of ways that people mask, right? So, that they try to hide the fact that they do or see or experience things differently than other people. And so, because they don’t want to seem different, right? So, our world is not always set up to be very accepting of people with differences. And so a lot of people want to not be different than the people around them. Unfortunately, this can lead to more stress, not asking for accommodations because just like Dr. Ebadi was saying, you don’t want to be perceived in a certain way. And sometimes, again, like because of cultural differences or other types of things as well, it may not be as socially acceptable in certain circles as well to say that there’s something that I need support with, I need accommodations for.

Cindy Lopez: So, our society seems to be set up for neurotypical people, those that kind of fit the mold, so to speak, right? So, I’m wondering, let’s flip that around, and I’m wondering specifically about our school system – like how is our current education system set up to support neurodiversity?

Melanie Hsu, PhD: That’s a very difficult question to answer succinctly, but basically in a lot of ways there isn’t a lot that is readily available. So, of course families can always ask for supports like IEPs, individual education programs, and other accommodations. But again, most public school systems are set up, like you said, to cater to the people right in the middle. So, what the vast majority of people are experiencing, unfortunately when there is neurodiversity, even if it isn’t again rising to the level of a clinical disorder, there can be these slight differences that lead up to more exhaustion, more stress, more difficulty with doing what other people are doing, without as much effort. And so, I do think that a lot of our school systems have a lot of really great intentions and want to support our students, but it’s really hard when you don’t necessarily understand what a neurodiverse presentation looks like, because it is so diverse, to find a one size fits all, which is what our education system often is set up for.

Marjan Ebadi, PhD: And most often, kids I think or parents have to be the advocates or actually asking for those things for school, and one of the best ways is to either ask for testing or evaluation because that can help one figure out how the child’s brain works. Not just like what it doesn’t do correctly, but more like what are some strengths, what are some things they can actually do really well, and then some things they need help with.

And then with evaluation, it’s a little bit easier because it can help parents and also kids themselves to know what they need and how to advocate for it better. So, one of the things that can help is figuring out what you need in the classroom setting and then taking it to class. Like, these are what I need to do, like extra time, or I need to stand up and do something, or walk around or take a break, but, unfortunately, as Dr. Hsu said, it won’t happen unless you advocate for yourself or you try to figure out answers for it.

Cindy Lopez: So, thinking about that, especially students in our education system, with their peers comparing themselves and seeing that they feel different–and Dr. Hsu, you talked about this a minute ago–but masking, I’m wondering about that. Let’s talk about that a little bit more. What is masking and how does the pressure to mask these neurodivergent traits impact the student, the child, especially with regard to mental health?

Melanie Hsu, PhD: So, masking is when we attempt to hide the amount of effort or the different things that we do to be able to get by in everyday life. This always comes at a cost of energy. So, you have to look at the situation, see how you would do it, assess what the neurotypical way would be, and then do something that’s out of the norm for you. And so no matter what, this takes a lot of vigilance. This takes a lot of energy. And because you’re masking, nobody knows how much energy you’re spending to do this. Everyone else can just take it for granted, and they have more energy to actually focus on the task itself. So, the effect of this often is exhaustion and avoidance. So, if you know that something is going to be really hard and you don’t know how much energy it’s going to take, it can be really hard to be motivated because it’s hard to do and you don’t always feel as successful. So, the effect that it has in terms of mental health is sometimes kids get more anxious, they get depressed, they have self-esteem issues, they blame themselves, they avoid, they get anxious, they get tired.

Cindy Lopez: Mm-hmm. And I think it’s probably fair to say it’s probably not all bad and not all good, and that all of us do it to some degree, right? It depends on the situation. Like for me, if I walk into a situation, I’m not really a big group person. So, I am going to mask that, might be strong to call it anxiety, but maybe, perhaps. But, I’m going to mask that and then I compensate. I’m going to find like one or two people in the room that I can talk to. So, I think we all do that in some way. And I think that we have to find, and for our kids too, find what works and what’s appropriate for the situation that they’re in and what’s socially acceptable. 

We know that many neurodivergent people describe masking as survival. Do they need to unlearn masking in any way? I mean, if it is about their survival, are there some things about masking that don’t work?

Marjan Ebadi, PhD: Like you said, we all mask, right? We have to meet certain norms and certain criteria, certain dynamics that happen in the work setting, but what happens with people who are neurodiverse, like Dr. Hsu said, it just uses so much energy of your mental stamina of day-to-day stuff because you’re going opposite of what your brain either wants you to do or needs to do. And then the other thing is not only you are sucking all the energy out of your brain, it impacts your confidence. So, then you end up talking less to other people or you stop comparing all the time.

So, then it just makes you kind of like a duck, right? You’re swimming underwater, but it looks normal. So, when it comes to it, I think what can be the most powerful tool is just helping kids understand what is happening with them, like, what’s happening in their brain. So, that could be part of the unlearning, like, hey, we’re not saying you can do whatever you want because that just can be disruptive or chaotic, but what is the best way to balance things that you need to do for yourself or like what allows you to be true to yourself for what your brain needs. And then also being able to build relationships with other people and go to work or go to school. So, there’s a lot of mostly finding the right balance about what I can do in this certain setting and then not trying to fit the mold. Because nobody can really fit that mold. But I think with kids who are neurodiverse or having a lot of shame about it, they might overdo it, then it becomes very tiring. And then, it kind of moves to the other side that we said can lead to anxiety, depression, a lot of self-harm and other things that can happen, or isolation. 

Melanie Hsu, PhD: Yeah, and to add to what Dr. Ebadi said, part of it is also being able to make a conscious choice, right? So, we know as adults that I am anxious in social situations and I can get myself ready, right? I can get my energy up, I can use my coping skills, and then I can go to that situation, I can mask, I can be very successful, and then I can go home and recharge because it’s a once thing. I know this is happening, but if this is every day, if you have to go to school every day, if you have to be successful every day, then that’s more problematic because you just don’t have as much time to recharge. You don’t have as much time to prepare. You don’t have as much energy overall. So, we’re not saying that one shouldn’t mask, just like Dr. Ebadi said. It’s a very healthy thing to know how to do, but the purpose is to be able to use it as a tool and not have to rely on it in order to get through what you need to do every day. So, giving individuals choices, giving them other skills, and then lessening the amount of pressure that there is, is helpful overall in mental health.

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Cindy Lopez: That picture that you described, Dr. Ebadi, like you see a duck on the surface. He is just swimming along and doesn’t look like it’s taking any energy at all. But under the surface, his feet are paddling and keeping him up and propelling him forward, and that’s a really good picture, I think, of what individuals who are neurodiverse are trying to do. On the surface it might look like they completely fit in and are making it work, but the challenge is for them that they have to make it work. And you have both said that Dr. Hsu and Dr. Ebadi, like there’s so much energy that goes into that and it can be exhausting. And if you’re trying to do that in school every day, you can see that would take its toll on a child. So given all that, we know, neurodiversity is part of our lives. We know that we have systems that are not really conducive to neurodiversity and we know that we all mask, and to cover up our differences.

So, let’s now talk about something that our listeners, I think care a lot about, and that is, what can they do? What can parents, caregivers do? What strategies can they use to support their neurodivergent kids?

Marjan Ebadi, PhD: Modeling always helps with kids so being able to model how they focus or how they interact in different settings or advocate for themselves. The other thing that we’ve seen work is, and kids themselves can actually start doing that, is what we call body doubling. Like, for a lot of college students, or regular students, like the one reason everyone likes studying coffee shop is because everyone’s kind of focused and they’re studying or at the library, like you see everyone else is focused. So your brain’s like, this is what I need to do. You can also do that at home with just hanging around your kids, like, working on your laptop while they’re doing homework, right? That could be another thing that you both working on something. And sometimes too, I think this happened a lot in a pandemic that there was videos of people working online. So, a lot of people, because you couldn’t go to coffee shop or library would have their videos on and then just watching other people work would help your brain to want to work and stay focused. So, those two could be something that can be used throughout the day.

Melanie Hsu, PhD: As the evaluation program manager, I always think about evaluations. So, I think what’s always really helpful is to understand ourselves. And to understand not only for the individual themselves, but also their support systems. So, this is caregivers, parents, teachers, it always starts with when you know yourself and you know why you do what you do and why you need what you need, you can forgive yourself for sometimes what feels like a shortcoming and it’s not a shortcoming, it’s a difference, right? And sometimes that difference really is a shortcoming, but knowing that range can be really helpful. So, a good comprehensive assessment can do a really good job of breaking down all the component pieces of possible neurodiversity and understanding that, and then building a mindful way of addressing those issues in a way that’s helpful for people. With that also is understanding and empathy, which the support system can then give the individual, and then the individual can have empathy for themselves. 

So, it’s very common for individuals to think, I’m just not trying hard enough. I could do this yesterday, why can’t I do it now? Why am I so tired all the time? Why can’t I just do it, right? And there are real neurological reasons why all of those things are hard and understanding doesn’t necessarily mean we’re excusing. It just means we’re understanding because all of us want to get this done. How are we going to find the best way of doing that? And so modeling that, like Dr. Ebadi said, with your caregiver saying, “Hey, I can see that this is difficult. Let’s break it down together.” I’m not going to say things like, “Just try harder.” I’m going to show you grace so that you can show grace to yourself. Individuals who are neurodiverse are typically very, very hard on themselves. So, they don’t need another level of people being hard on them. They’re hard enough on themselves.

And then just having normal conversations. A lot of times, again, as an assessor, what I see often is that neurodiversity is also seen in the family. And a lot of times caregivers have their own strategies that they don’t even necessarily realize are strategies, and that can be super validating for an individual to hear like, “Oh my gosh, my mom or my dad is the person that I look up to. And what do you mean you guys also have the same issues?” It can give you hope that things will get better and that it’s okay to ask for help and support.

Marjan Ebadi, PhD: Adding one more thing too, as Dr. Hsu said, like they do focus on all the negatives. So, the other thing is trying to help them see the strengths and the things they actually do and succeed in, right? So, naming them if they do something really fast, so like, “You read that really quickly” or “You made friends.” Just naming and labeling things can also help them shift from, I can’t do something to like, oh, I actually did a lot of stuff today that I didn’t celebrate.

Cindy Lopez: Yes, and there are so many people who are neurodiverse and very successful or that we recognize as successful in our world and so that might be another thing for parents and caregivers to look at too. Like, hey, it might be difficult now, but there’s going to be opportunity for the way your brain thinks and works and that could be a real strength as you move out of school and into adulthood and life and bringing up some of those successful people might be helpful depending on what your child is interested in.

There’s Charles Schwab. There’s some sports figures like Gary Payton on the Warriors. There are really successful business people, Bill Gates, and others. So, it might be good to recognize those people and bring them into the conversation so your child can understand, like it’s going to get maybe not easier, but they’re going to find the place where they fit and can feel successful, and you can help them do that as their parent or caregiver by just having these conversations, helping them understand how their brain works and why it’s different and strengths as you already noted, Dr. Ebadi.

Marjan Ebadi, PhD: One more thing too, just remind kids whatever challenge they’re experiencing is maybe just now and it’s not who they are or it’s not their whole self or their whole worth, but it’s just something they’re dealing with at this point in time. And once we can find the tools or fix the setting, or depending on what it is, that could change, and it’s not going to be your whole life. It’s just at this point in time might be very challenging, and it’s workable.

Cindy Lopez: Yeah, I think that’s good for parents and caregivers to say that to themselves too. This is for now, in this season or this point in time, it’s very challenging. For kids, they may not be able to understand that it’s just a point in time. It’s like, are you kidding me? This is my life right now. So, all of that needs to be part of the conversation. It’s important to have those conversations with your kids who are neurodiverse.

Melanie Hsu, PhD: And another thing also is finding a cohort for your child. So finding other individuals who also are neurodiverse can be very validating that you’re not alone. And it’s not just mom and dad just trying to make me feel better or trying to take care of me. It’s actual people who are like me and are also not like me in some ways to really understand again, all the things that Dr. Ebadi said, as well as what Cindy said about the season of life, right? And so other older kids that have gone before you, other teens, people who are like you, people who are not like you, that give you a broader perspective.

Cindy Lopez: My experience is education, about 40 years in education – and in education working with kids with learning differences, one of the greatest things is when they are in a learning environment that recognizes that neurodiversity. And, is able to support the neurodiversity in a way that makes them feel accepted and feels a sense of belonging. That’s really important. And sometimes, for parents that might mean looking for a different type of learning environment. And, a plug for Sand Hill School here at CHC is a place for kids who think differently.

And I know that the experience I had at Sand Hill as the founding head of Sand Hill, so many families, so many kids, who went there said, “Oh my gosh, I finally found the place where I fit in. I finally found my tribe,” like, this is where I was meant to be. So, the learning environment and how you choose that, how you find that for your child is important too.

So, Dr. Hsu And Dr. Ebadi, thank you again for joining us today and for this conversation about neurodiversity and what it’s like being neurodiverse in a neurotypical world. What is it that you’d like our listeners to really hear from you today?

Marjan Ebadi, PhD: I think one thing that’s important to remember is that you’re not alone, and you’re not the only one experiencing these challenges. There is a world of different types of people with different types of brains and different strengths and challenges. And one thing to remember is your uniqueness makes the world a better place. And I think the other thing important to remember is find your cohort and be able to learn more about yourself. For many of these things, it’s like a lifelong condition, right? So, things will shift and change as you get older. And some things might be a lot harder and some things might be easier. But, just be kind to yourself and keep learning because that’s going to be one thing that’s going to celebrate you and who you want to be.

Melanie Hsu, PhD: It’s built into the name right? Diversity. Neurodiverse. There are so many different presentations and so a lot of times you can feel very alone in that, but there are many, many people who are very neurodiverse in many different ways. And like Dr. Ebadi says, it makes our world a very colorful and vibrant place to be. And things may be difficult at this time, but things always move forward and things always change. You will continue to grow. You will continue to move forward and there’s an excitement in that as well as our world learns to be more accepting and to be more accommodating of people who are neurodiverse.

And understanding that the concept of neurodiversity doesn’t equal bad, it just means different. And so, we want to encourage everyone again to be unique and be diverse, but also to be forgiving of themselves when things seem a little bit harder. And then to ask for help and to ask for support because you may also be helping to advocate for another person who has similar struggles who isn’t able to ask for that support. Sometimes that can help us be more willing to ask for support for ourselves when we think this, in turn, may be helping someone else that I don’t know.

Cindy Lopez: Thank you so much for those words, Dr. Ebadi and Dr. Hsu and for our listeners as Dr. Hsu said, don’t be afraid to ask for help. And if you are a parent of a neurodiverse child and you need some help, please feel free to reach out to CHC. We have parent coaching services. We have, as Dr. Hsu mentioned, we do assessments or evaluations, where you can find out a little bit more about what’s going on with your child or a lot more about what’s going on with your child in order to help them, just getting more information and understanding what’s going on. So, you can email the care team at careteam@chconline.org, or you can call us at 650-688-3625. Thanks so much for listening today.

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