Julie Legg chats with Emily Cox, a licensed therapist from North Carolina, USA, exploring the challenges and triumphs of navigating life as a neurodivergent teen or young adult.
Drawing on her personal and professional journey, Emily sheds light on the social and emotional hurdles young people often encounter and shares her therapeutic approach, which focuses on empowering clients to harness their unique strengths and thrive.
KEY TAKEAWAYS
- Social and Communication Challenges: Teens and young adults often face difficulties in expressing their thoughts and navigating social interactions. Emily emphasizes the importance of creating safe spaces where they can learn alternative ways to communicate and connect.
- Therapeutic Approach: Emily uses creative and adaptive methods tailored to individual needs, whether it’s working through trauma, regulating emotions, or finding nonverbal ways to express feelings.
- Strengths Over Fixes: Therapy is not about “fixing” neurodivergence but empowering individuals to utilize their unique abilities as tools for success.
- Fostering Self-Confidence: By reframing neurodivergence as a source of strength, Emily helps clients build self-acceptance and confidence.
- Personal and Professional Journey: Diagnosed as neurodivergent in childhood, Emily’s experiences of feeling different in a time of greater stigma fueled her passion for mental health advocacy.
LINKS
- Emily Cox’s website
- Emily Cox Instagram
- Julie Legg author: The Missing Piece – A Woman’s Guide to Understanding, Diagnosing and Living with ADHD
- ADHDifference Instagram
TRANSCRIPT
JULIE: I’m Julie Legg, author of The Missing Piece and diagnosed with ADHD at 52. Welcome to ADHDifference. In this episode I’m delighted to be chatting with Emily Cox. She’s a licensed therapist working in North Carolina. She’s neurodivergent and has neurodivergent clients too, mainly dealing with children, teens, and young adults. We talk about some of the common challenges they face and some coping strategies to help them. Thank you so much for joining me today, Emily.
EMILY: Yes, it’s so wonderful to be here. Thank you for having me.
JULIE: Most welcome. Look we’ll dive straight into it. You’re a licensed therapist working with neurodivergent clients, which is fabulous, and I’d really love to hear your journey into the neurodivergent world.
EMILY: You’ll have to bear with me. As a typical neurodivergent human, I will take the long route. So we go on a long and winding journey of how I got here. It’ll be typical of how I explain things. We don’t do typically; we don’t do things like point A to point B. It’s like point S to T to U to B … to maybe we’ll get to B eventually. But yeah, I have background of personally having some like diagnostic adventures, and adventures in childhood with being identified as neurodivergent. At the time that was really challenging because there’s been a lot of great changes in the world in terms of like reducing stigma, and talking about personal experience, and kind of having this breadth of experiences. And not like “You have to fit in this box and if you don’t have this exact criteria then you don’t meet.” But kind of back when I was diagnosed in childhood, it was much more like that was a bad thing. I didn’t want to be different. I didn’t want to be with the bad kids. I don’t want to be separated into the special classroom. Like, I was very avoidant of any potential diagnosis or any potential thing like setting me apart. Developmentally at that age I was kind of like “Ohh, I don’t want to be different.” Like “I don’t want some letters coming along with me. Ohhh, I don’t know what this means but it means that I’m off or funky or weird. I don’t want to be that. I just want to fit in.” So it was kind of some challenges through that and then how I got into mental health field and wanting to work with others and help others. And really working to like identify and hone others strengths. So a lot of times the things that lead us to therapy like it’s not because things are going super-duper well. Ideally that should be where our lives should be and we love it when life is going well but sometimes things get overwhelming. Things get challenging. Things get really intense and that it’s like I can’t see, you know, the forest for the trees anymore. I can’t figure this out. I feel like I’m in a cloud. I’m in a veil and I can’t see the path forward. So sometimes that’s when people seek out help and are like “Can I get someone else to give me some sense of direction or support or clarity.” So within that I try to be really like strengths focused, that it’s not like what’s wrong, what’s different, what did we you know what path didn’t we take? But more of like hey what is helpful for us? What are our inner tools? What are inner strengths that can help us guide along this path? We may not be able to see exactly what it is but we know that we have the tools along the way to handle it.
JULIE: And of all of your choices, you know, at that tender age when you’re looking at career choices and paths, what led you in the direction of therapy?
EMILY: Yeah I had a really … this is typical for a lot of people, I had a really amazing therapist in college. And when I was first kind of in university path I think I changed Majors like seven to eight times. I did not know what I wanted to be or wanted to do. And everything I tried on like I could kind of sort of see myself do it but then I was like “I hate math.” And like “I want to be a lawyer but I don’t like writing things,” and like ahhhh. And it really was kind of having a super transformative experience in my own personal therapy journey that I felt kind of a calling to it, of like hey this has been so beneficial and helpful to me that I would love to support others in this. Now as part of that, and I think it is an important part of the further education and training of therapists and counsellors of like doing our own deconstruction work as well. So that we’re not stepping into this like ‘saviour’ or ‘fixer’ mode but that like “Hey I’m not here, I don’t have all the keys to your success to be like I can fix it. I can do this. My magic wand is in the shop,” but more of like “Hey how can I walk along someone? How can I be part of the journey and part of the experience and not just like someone on the mountaintop giving someone these directives of what to do.” So I think that was kind of a really important part of my training as well of like hey not only the calling to it but also the reflection and the inner work of like how can I really be helpful. Just because you’re called to something or just because you want to help doesn’t mean that it’s the best like support or service for that.
JULIE: I think too having a lived experience with neurodiversity, and ADHD, and all of the other partners that you know come along with that, I think it is really reassuring for the client too that they understand you know going off on tangents, or losing one’s train of thought, or you know zoning out perhaps at times. And I think it’s really reassuring to have a therapist that understands that, you know, from the get-go which is brilliant. And you’re a licensed therapist. Can you tell me more about the kind of work that you do with neurodivergent clients?
EMILY: Yeah, I mainly work with like teens, young adults, some adults but most of them, all of them, are somewhere along the neurodivergent spectrum. Sometimes we have a lot of LGBTIQ thrown in there as well, of like okay let’s add in all the things and have all the different ways of experiencing the world and kind of finding our identity and our way of drawing our path into the life. I think part of that drew me to that was kind of lived experience therapy is such a vulnerable and like intense experience sometimes. Like it’s so hard to reach out for help and that takes like a lot of bravery and a lot of intentionality that can be really you know … sometimes we want to be like “I got it. I have this. I can handle it. I can do this.” It’s really hard to be like “I don’t got it. I don’t know what I’m doing. Like, I don’t know what’s up. Like, I need help here,” is such a vulnerable and like scary process in of itself. So I think a lot of clients and people find it really like reassuring and reflecting of like “Oh wait. There’s some level of understanding. There’s some level of like you get it. Like, okay, I’m not just having to like explain this new thing or da-da-da. Or like I’m talking to someone they’re just staring at me like I’m a blank face, that I have three heads. I’m like cool. What do you mean this isn’t normal that like everyone does this stuff? I thought like everyone went through this?” They’re like “Now I have to go through my whole life story all over again.” Like, I totally hold a lot of space for the vulnerability and like intensity of that. So part of it having that like “Hey I have some level of understanding and some level of lived experience that is relevant to that.” I also too I’m really drawn to working with neurodivergent clients just because the creativity and the way of processing information that is like not neurotypical is so like it brings about such creativity and like openness in problem solving and in finding new ways. I do a lot of narrative work. I do a lot of metaphor, a lot of sand drawing and expressive art, so things kind of outside traditional talk therapy. But with that like, the ways that we can discuss our lives, or discuss our challenges, or find connections, or find meaning to us in certain ways you know, I would have never found those pathways, or would have never pointed it out that way, but then someone can come with this beautiful metaphor. Or someone can be like “I feel like I’m drowning under the weight of all these things,” and put it into words that have so much meaning for them and that are so helpful in the therapeutic process. So like I’m just continually like impressed, and enthralled, and like supportive of all the strengths of the neurodivergent experience. I think it takes a lot of like bravery, and courage, and resiliency to go through … like the life. the world is not designed for neurodivergents, let’s just be real about that. So like every day to feel like “Okay well I have to do these things 20% extra,” or like “I feel like I’m that you know, round peg going into that square hole and I feel like I have to fit myself into this box.” So to like unmask, or to release, or to be is like such a beautiful thing to support, and to witness, and to hold space for.
JULIE: Absolutely. Now tell me, your younger clients, I imagine they have the support of family, parents bringing them along. With your teens and young adults, do they have support around them or are they coming to you really on their own, so to speak? Do you know, can you tell me about the how important support from family and elsewhere in the community can be during this process?
EMILY: Totally. It really depends of clientele. Sometimes there’s a really great support network and sometimes there can be a really great like found family network. So sometimes our like nuclear biological families might not understand in certain ways, or might not see us, or there’s kind of this like narrative that we’ve been growing up with. So that we might have been labelled like the ‘difficult child’ or the you know ‘rambunctious child’ or the ‘hard child’ or the ‘sensitive child’. A lot of the diagnostic criteria for ADHD and autism was written with like male identifying people in mind and it was done with a lot of research on boys specifically. So a lot of female identifying people have a really hard time with like going through the world, coming to a reckoning with neurodivergent identity, or even like I can’t even tell you … well, a huge percent of my practice is like “Have we ever considered evaluation for ADHD and autism?” And a huge majority are like “What are you talking about? Like I just have really high anxiety.” It’s like mmm? We seem to process the world in a different way. We seem to be coming up against these similar like patterns or things that are happening over and over. And what I see really commonly is like this internalization piece. So not only the piece of like social stuff is what I see a lot. So a found family, not feeling right, you know, affirmed or how you are accepted as identity in biological family. Or like it’s a lot of social stuff. So what will happen with social stuff is like “I you know, I really want my friends to be there and I try to be the best friend possible and I do everything. And I make cookies and I make cupcakes but then like no one shows up for my birthday. And it happens over and over again. It’s because I’m not a good enough friend. It’s because I’m not worthy. It’s because I’m not enough.” It’s like, wait a minute. Did we ever talk to our friends and say that cupcakes are meaningful to us? Did we ever articulate that we need this thing or did we just internally see that was a pattern and we just non-verbally we’re like “Well I’m showing you how I want friendship to be and exactly what it wants to look like but I don’t need to verbalize that. That’s so scary and too much, and that would be a weird conversation. But like how dare you not give me the exact friendship experience that I want?” So it’s a lot of that of like those patterns coming up over and over again. And then I talk a lot with clients of like that diagnoses don’t have to be boxes that we fit into but they can kind of just be like a lens that we perceive the world through. So it doesn’t have to be “I am this,” or “I am that.” Some people find that really affirming and really helpful and like the first thing is like “My name’s Emily and I have ADHD.” And like if that’s affirming and really helpful for you, fabulous. Some people find that really overwhelming and challenging. Or like another label, or like the understanding and the meaning making like internally can be challenging. So it’s like … it doesn’t have to be the entirety of who we are. It can be the lens of like “Oh wait, I might meet criteria for this or like I self-identify or I self-diagnose as this. That means that these situations might be more challenging for me. Or that this is really hard for me and these are the things I can do to support myself. So in terms of support networks like even if it’s not found in like the biological family or found family, more of like hey having some support for ourselves and then being able to reach out and seek that support when needed.
JULIE: That’s wonderful and I think having that sounding board and particularly talking to a, you know, a licensed therapist that knows what they’re talking about I think is really important too because often we will go through our lives based on our own personal experiences and do what we’ve always done. And in some parts be quite angry or frustrated that we’re misunderstood and all of those things. But to re-framework certain situations, as you were talking about the cupcakes earlier. Now as a nonverbal thing, it’s what you’ve always done and you expect a certain outcome … This is how I show love. This is how I show friendship. This is how it works for me. But to turn it, to tweak it and to think oh I’ve actually never told anyone how important it is to me I think that’s really good. And I think often we need to challenge ourselves and to see how we can see things in in other ways. Particularly our communication skills I think can be quite tricky in social environments. With that, what other challenges are your clients having? What are some common challenges that they come to you with?
EMILY: Yeah, I think the probably the most common is the social because a lot of times a lot of the diagnostic criteria is written to like hyperactivity or inattentiveness. It’s also to like the extremes. So sometimes when people are diagnosed with autism spectrum disorder they’re like well I’m not having like the hand flapping, or the head banging. Or I’m like I can handle different textures at different times and it’s like well, if that’s the most extreme end of the spectrum where it’s like we have some challenges with functionality. We have some challenges with self-care task. We have some challenges with hygiene. Like, yes that might be representative of the more like severe end of the spectrum. But kind of in the middle or the lower end we might just have some sensory needs. Or we might get overwhelmed and it might have been contextualized as like “Hmmm, you need anger management,” or like “You’re really explosive and like you might have bipolar.” When it’s like, wait a minute. Like there might be something else going on. We don’t like tags on any of our clothes. Hmmm. So sometimes it’s like that, like the social ones aren’t as fully discussed in the diagnostic criteria. So it’s more of these patterns of like “I am so seeking deep meaningful friendships or deep meaningful relationships in my life and I feel like I’m incapable of having them. Or I keep trying and they keep slipping through my fingers.” And so like those are the words being used but it’s really describing of like but wait, I have a really hard time communicating my social needs. Or my social attunement is so high that I’m picking up on every possible frequency that I can and I’m making it that, or I am perceiving it that it’s because I’ve done something wrong, or that I’m not good enough in some way. Versus like we didn’t get that message. We’ve told ourselves that message through the internalization of the like external information. So there’s those pieces. A lot of it too can be so like friendship, social, things occupational. So whether it’s like school or work it’s that executive functioning piece of like “I keep getting late charges on all my bills but like I can pay my bills I just forget that they are. Or like forget what day they’re on. I am really loving my job. I love doing what I do at work but like I keep meeting, I keep missing deadlines. Or my boss keeps pulling me in about productivity or about how I’m doing at work. And I love what I do but I feel like I just am missing the bar every time.” There’s a really common overlap between ADHD specifically and women or female identifying people and perfectionism. And when I reflect that to a lot of clients they’re like “What are you talking about? Like I don’t know where my car keys are. I lose my sunglasses on my head. I can’t figure out like how to get out the door in the morning. Like I am type B. I am the least organized like a perfectionist person? What are you talking about?” Well how it shows up is like I … “Unless it’s going to be perfect I shouldn’t do it at all. Unless it’s going to be the most amazing assignment or the most amazing project, I shouldn’t even start it. I have to do the best at my taxes or I won’t even start them. I know they’re looming. I know the tax day is due, whenever tax day is, but like I can’t even start it because I have to be the best at it. It has to be amazing or it’s garbage.” It’s that extreme, that black and white thinking that is very like indicative of kind of neurodivergents and perfectionism. And then being like “Why can’t I get anything done? Why? I just procrastinate really hard.” It’s like, wait a minute. There’s a piece of that procrastination. There’s also a bigger piece of that that is about like self-worth, and self like perception, and vision. And then like how we are accepting like adequacy and like being mediocre, which can be really triggering for a lot of neurodivergents because it’s like, what? “What do you mean? I’m the best at this or I’m the worst at this. I can’t just be medium.” And I’m like, these… like 60% still counts. Like doing it a little bit and not having to be 100 or zero.
JULIE: And with every challenge that ADHD and other neurodiversities can bring to the table into our daily lives of course there’s the upside. There’s our strengths. And as part of your work do you help identify strengths in individuals that they might not believe exist, if you know what I mean? If they’re down on themselves so to speak, and they can’t see the wood for the trees, are you able to help them identify their strengths too?
EMILY: Totally. I think that’s such an important goal of like working with the therapeutic process and working together with people in therapy. That it’s not just identifying challenges or problems or things we want to improve but like things that are going well. Or things that we’ve like accomplished or done well at, or that we can recognize that. Sometimes it’s building that skill as well of like giving our self-credit, giving our self-grace. Sometimes that starts at zero and it’s like “No, it’s terrible, everything’s awful.” It’s like we got a starting point. We started the walk on the journey, it’s okay. But having that piece of like “Oh wait, I did it a little bit differently this time. I didn’t have to do it perfectly. I have to change.” A lot of time with neurodivergents, we want to have immediate change, right? We want immediate gratification. So it’s like “Hello therapist. Tell me how to make anxiety go away right now. I want all of my insomnia to disappear. So you’re going to teach me some deep breathing things. And when the deep breathing doesn’t work and I’m still staying up at 3:00 in the morning, it’s because therapy sucks and this is stupid. And I should never do it again, and da-da-da.” That could be one experience. I talk a lot with people about like realistic goal setting and like that it is incremental changes, baby steps, and giving ourselves grace and like time to just try and to fail if needed. Even if we fail we get information out of it. We get really critical helpful information. That’s like “Okay well that didn’t work okay. I tried that and I really didn’t like it. Okay well I tried that and the world didn’t explode. I like set a boundary and no one like pointed at me and told me that I was a horrible awful person.” What? Like that’s really critical helpful, sometimes life-changing information. There’s pieces of it of like building on those strengths and like through the change process building that awareness and like gratitude for that change, no matter how big or small. It might be but like “I keep having these patterns. I keep having stuff like, what is wrong with me? Why can’t I do this? I do this wrong. And then building the space of like wait, I did it a little differently. You’re like wait, I did it this way. I didn’t totally fail at this. It might not have been a magical fireworks blazing success but also like I’m not a total complete failure.” Building in that like gray area is a real big piece of it that’s part of like recognizing and building upon the strengths.
JULIE: Absolutely and I believe everybody has strengths and it is a matter of finding them and believing in them. And of course, we’ve got impostor syndrome where even if we are good at something we self-doubt and think “Oh no we probably not.” Or we have a saying ‘a tall poppy syndrome’ I don’t know if you … yeah, but you know “I shouldn’t really be that proud of the good side of me because then it would look bad. And there’s more negatives than positives so therefore I’ll go with a common negative, you know …on the scale.”
EMILY: “Everyone is just lying to me,” is what I hear a lot. “Well and everyone just is when they say I’m doing a good job, they’re all just lying. Everyone’s just in on this big giant cosmic joke that I’m like failing at this but while I’m really doing a good job.” It’s like what? That’s a lot of mental gymnastics to get there.
JULIE: Isn’t it, isn’t it just. But we can use our strengths to actually combat some of our more challenging traits as well, which is nice to work with our strengths to iron out some of the rougher spots, so to speak. And you use coping tools of course in your therapy. I’d love to chat to you about some coping mechanisms for two subjects really. One is big emotions and that overwhelm of emotion that we … that can come in surges at the most unexpected of times. And also stress. Are you able to talk to those two subjects for me please?
EMILY: Yeah. Totally. I think emotional regulation is like a huge piece of the neurodivergent experience. I think from my work with a lot of clients, it seems like a lot of times they’re like … even if we get really good social emotional learning, sometimes we didn’t and it just was like Barney or like “Say you’re sorry and then everything’s fine.” But like in terms of actually learning how to develop and maintain like social skills and personal emotional regulation skills like that was kind of lacking. Even if it is there, sometimes it’s more of this like linear like exposure to it. But it’s like ‘if this, then that or ‘this, then that’ and like sometimes that doesn’t work as well with the neurodivergent brain or the neurodivergent experience. Like everyone else is nodding along and like “Yeah this makes sense”, and someone is sitting in a classroom like “Wait, what? I don’t, whatever. I would rather finish my math homework. Like I can’t pay attention to this right now.” Totally understandable. So the like emotional regulation piece I … my experience with clients is people are kind of like piecemealing it. Or like just doing something because it works in the moment and then going with that and like “That’s the one coping tool we use forever for life and that’s it.” And sometimes that coping tool is like naps and sleep. And I’m like “Great, we have a coping tool but like we can’t just be unconscious all the time. So like what are we going to do when we’re vertical because I see some vertical time in our future at some point.” So with that of like working on emotional regulation a big piece of that is the sematic experience, so keying into our bodies. A lot of time neurodivergents are really good at processing a lot of information very quickly and it’s very like mental focused and like intellectually focused. So like intellectualizing – big piece of it. Rationalization – big piece of it. So like the attunement and going-ons of the rational brain is like in overdrive and then the like experience of being in our bodies is like “Nahhh. I don’t know, what? A body? Deep breathing? Gross. I breathe all the time. I don’t need to do any of that.” So it’s kind of kicking in though of our like sematic experience and our like body needs. Whether that is just the basic halt, hungry, angry, lonely, tired, like how are we feeling with those things and how that’s affecting our current emotional regulation. Whether we are thirsty, whether we just need some basic needs and that’s the basic sematic coping tools of whether that be deep breathing, whether that be tapping. I like a lot of baseline things, I’ll be like “Do we need to just go outside and like be in the sunshine for 5 minutes?” So it’s not … this is where all or nothing comes in, of like “I need to walk two miles every day and if I miss a day, if there’s ice outside, or it’s a monsoon, or I don’t feel great, then I failed and I’m going to be terrible and awful forever.” Of like some days if we feel like walking, great. Some days if we just want to be outside for five minutes that counts as being outside for 5 minutes. I talk a lot of like having a coping tools menu, kind of. So like instead of having a list of 20 million things or like “I’m going to write down all my resolutions and I’m going to achieve these 10 goals by March and it’s going to happen every day.” Of like three to five things, five max, and from different areas. So it could be like if there’s a comfort TV show, if there’s a comfort movie, if we like listening to a certain artist or a certain playlist, like having that kind of outlet. Doing a creative thing. If we like drawing, or coloring, or crocheting, like that would be … yoga. Meditation can be hard for a lot of people. It’s like “Huh? My whole life is running fast and you want me to sit still?” But more of like guided meditation. 3 to five minutes, if it’s helpful for us. If not, take it off. So like different areas of things that are helpful to us and then kind of evaluating of like “Oh that was really helpful. I hated that.” Okay, take it off the menu. Different contexts are going to have different things that works. Sometimes with the neurodivergent brain we’re like “This deep breathing didn’t help me with this panic attack therefore I should never do deep breathing and it’s useless to me.” That could be a piece of information also like in that specific context that wasn’t like the helpful-est tool, the most helpful tool in that way. So like we were trying to use a band-aid over like a bleeding wound and it’s like “Wow, why didn’t that band-aid stop all that bleeding? How dare!” But more of like “Hey, we might need a combination of things or we might need to like kind of isolate or get to a calmer space before any of that works.” So kind of having that coping tool menu. Similarly with stress. I see a lot of stress with like the executive functioning piece of like we’re trying to handle so many things and like juggle so many balls and trying to like have octopus hands and handle all of it. And be like “I can’t let any drop.”And it’s more of like kind of differentiating like which balls are rubber, and which balls are glass. So some like they’re going to fall. Which ones are going to shatter everywhere? Which ones can bounce back? And if they shatter everywhere we can also pick up the pieces. It’s not going to be fun. We might get shards of glass in our hand or in our feet, but like we also have the tools to clean that up as well. That it’s not just like “I have to be doing everything, all the time, always, or ….” But more of like “Hey, I’m allowed to have space. I’m allowed to have boundaries. I’m allowed to have rest.” And giving ourselves permission to have that time.
JULIE: Wonderful, wonderful words of advice there and putting it into practice I guess takes practice. And you can’t expect, as you said before, you can’t expect to implement new strategies and expect them to work immediately. And there are different times for different strategies and tools too, isn’t it. You can’t necessarily apply the same thing to everything. What do you love most about your work, Emily?
EMILY: There are so many things about it. That’s such a good question. I love that it’s different and new and exciting each time. So like it’s not, it sounds weird because similar things each day of like the … I have to say of like inviting people into the sandbox. So like the sandbox is technically the same but like the tools and toys and adventures that we go on are always different.
JULIE: So please tell me about the sand box. I’d love you to expand more about that.
EMILY: Yeah, so it’s this metaphor of like, therapy space is kind of like a sacred space or like a grounded space. In that like if I’m asking a client or a human to be like “Nice to meet you. Please tell me your deepest darkest secret and your biggest trauma and the most horrible thing your mother ever said to you.” Like that would be really confrontational and like overwhelming and challenging. So there’s a big piece of like setting safety and having like safe like guide around guidelines and boundaries around it. And then also like having it be a conversational back and forth, that like if there’s something that has kind of stepped the lines of that safety, or that like we’re exploring within it but it still feels kind of icky, that like it’s an open conversation about it. So there’s metaphor of it’s kind of like set up like the sandbox. Like when you’re in the sandbox you kind of know the boundaries of it. Within it you can do kind of whatever you want and like you can do certain things. There are consequences. So like if we throw sand everywhere someone’s going to be like “Oh man, you threw sand everywhere!” If we you know build a really big sand castle and someone else comes and knocks it down we’re going to have a response to that. If we lose our toy in the sandbox. If we come back and the toy that we played with last time isn’t there like we’re going to have really different experiences in the sandbox. But we know it’s like a safe space and a boundaried space to kind of work through and then practice the things that we want to before going out into the world where we have expectations, and rules, and guidelines, and da-da-da. And all these things. But like “Oh, wait. I can just like have some time in the sandbox. If I need to just sit and like you know dust my fingertips in the sand, that’s okay. If I need to like stomp around and make a big giant hole in the sand, we can do that too. That like everything’s allowed and accepted because it’s that safe space that has that like mutual respect and arrangement around it.
JULIE: Thank you for explaining that. That makes perfect sense to me. And what a glorious space to be in, in such an intimate time when you’re really digging deep into some of your yeah, very very personal details. And to feel in a safe space like that is really 100% required. Now Emily, you’re based in North Carolina. How does your therapy work? Is it done in person or is it done online? How does it work? I do a mix of both.
EMILY: So I have some online virtual sessions and I have some in-person sessions in an office in Asheville, North Carolina. I personally like the mix of both. Some people like being totally virtual and like doing all the virtual things. Some people are like “No, I will only see people in person. In-person therapy it’s where it’s at.” I kind of like having the mix of it and kind of being flexible to meet people’s needs. A lot of the time especially with my teener kid clients like a lot of people went virtual full-time due to the covid-19 pandemic so kind of transitioning away from that. And so a lot of people who were working with children at the time were like “No. Virtual is awful. Like …. school’s virtual, everything’s virtual. This is terrible.” With a lot of my teen clients, it just really depends on each individual client. So some people like are really craving that in-person kind of feedback and sitting and like getting all that information you can be sitting in the same space as someone physically. Some people it’s like it’s really convenient to join from your phone. Or, to not have to drive and park and deal and da-da-da. Of like in between studying, between work, and between soccer practice, to like login. It’s your tablet. It’s your device. It’s your time. You can kind of set it up in your cozy space in your room and then like kind of talk with your person and connect in your therapy journey. That people some find it to be really convenient and really helpful. So I don’t find any piece of it of like “This is the best.” Or, “This is the worst,” or “This is the gold standard,” or “This is bulk standard,” of like I just like having the options to provide to people what’s best going to meet their needs.
JULIE: And as far as clients go, when would be the opportune time when someone thinks “You know what? I’m going to give therapy a go.” Where typically are they in their lives? Have they reached rock bottom, or are they wanting to test the waters, or curious or …. Typically what’s sort of … where are they at in their lives when they come and seek you out?
EMILY: Yeah, totally depends. One of my questions … we do like phone consultations before we meet for the first session. So one of my phone consultation questions are like “Why therapy? Why now?” Sometimes we’re like at the end of our rope and we’re like “Ah! I’m like holding on by a fingertip on the edge of this cliff.” And we’re like “I need something now or like horrible things are going to happen. I’m just … I’ve been you know, white knuckling life for the past 15 years and like I need help now.” And like if that’s the space we’re in, that’s the space we’re in. Sometimes it’s like “Hey, I’ve been noticing some stuff happening or like things are harder than they used to be. I’m responding differently. Things that didn’t used to set me off, set me off.” A big piece with like when I’m screening for depression I ask a lot about like agitation or irritation. So sometimes it’s not just totally depressed mood of like “I’m sad. I can’t get out of bed,” but like “Everything sets me off. Or like everyone who speaks to me just like pisses me off and I can’t deal. I used to be able to like deal with it but then like someone cut me off in traffic and like I feel like they’re the worst person ever and how dare they ever do something that horrible to me.” So like the intensity of our response kind of can change and be like “Maybe this is something that I should like discuss about.” Sometimes it’s a proactive thing. People move. People change. Changing schools. Going to college. Kind of having shifts in friend group. Kind of having changes in family units of kind of separations, divorces, remarriages, new siblings. Sometimes it can be a proactive piece of like “Hey, we see this change coming or this recent change happened, we just want to like have some space for it.” Beautiful, wonderful, amazing. So there’s no typical of like “You should definitely seek if do this.” I think it’s a really important piece to like have clients be empowered in the therapeutic process and not just be totally like didactive and directive of like “You do this now, and here’s your worksheet, and here you do this.” Some people really love that approach and that can be really helpful to them but to have a space that is like “Hey, what is going to be helpful for you? What are you going to find like most meaningful about having this space or about this process?” And that answer doesn’t have to be fully formed. It can be “I don’t know.” That can be a totally valid answer. That’s why the piece of like ‘why therapy? why now?’ kind of gives us some insight of to like “Hey, what am I looking for out of this? What I’m looking to change?” Sometimes the things that we walk in on day one of like “I hate my partner and they get on my nerves,” is like not actually what’s going on. We can talk about it. We can have some strategies around it. We can like have some tools around that. But it’s more of like “Oh there’s other things happening. Oh, wait. I experience the world in a different way that presents differently but I also have all these like strengths and tools that because I like interpret the world in a different way, I get to see things that other people don’t.”
JULIE: Yes and it’s difficult if you’ve only ever known your own brain, which is all we ever know, we can only imagine, or through observation imagine, what everyone else is thinking or how they do things. And I definitely remember growing up just assuming that everyone thought the way I did and getting quite frustrated and confused that their reactions weren’t the same as mine. Because surely, surely, we’re seeing the same situation unfurl.
EMILY: Right. Right. We’re all doing the same party. It happens with families too. Like as adulthoods, like leaving family life and going into more like individual adulthood life, when we’re kids we think everyone’s family like it all looks the same. And we’re like oh, it’s all like this. When we go to other people’s houses we’re like “Wait, what? Huh? This is different. What do you mean? Doesn’t everyone just do this on Friday night? Huh?” It can be like an earth-shattering revelation.
JULIE: Yeah. Another too I think is you know, there’s certainly a strong genetic link with ADHD. And I think if you’re growing up in a household where basically it’s reinforced that what you’re experiencing is absolutely normal. And potentially a parent themselves have undiagnosed … or some kind of neurodiversity themselves and therefore it’s normal to them. And reassuring you that what you’re going through is absolutely normal as well, it can be quite a shock really, yeah, when it is presented in a different way.
EMILY: Yeah, “You’re just unique. You’re just special.” Yeah “You’re just really … you just have, you go to the beat of your own drum. There is nothing, like we’re all… we don’t need to like go to a psychologist or like talk to anybody know. You just figure out your own way.” Which like they’re not mutually exclusive. Like both can be true.
JULIE: Yeah. Absolutely, definitely. Emily it’s been wonderful chatting to you. In the show notes we’ll have your website details and contact information if anyone listening would like to contact you. I’ve really appreciated your time today and so thanks so much for walking me through your therapy sessions.
EMILY: Of course. Thank you so much for having me. It was great talking with you.