Unbridled Self-Expression in the Therapy Room
For some neurodiverse people, including some with ADHD and autism, ‘unbridled self-expression’ can be a trait impacting successful communication with others, including therapists.
Understanding ‘Unbridled Self-Expression’ in the Context of Neuro Wiring
The need to speak in order to clarify thoughts and feelings for the self
Feelings can arrive at full intensity
Impulsivity can cause the need for connection to bypass social filters
Masking fatigue can cause a flood of expression when the mask comes off
Some nervous systems need to express feelings in order to regulate
A part (in terms of Internal Family Systems ‘parts’) that protects the silenced part of the self, is speaking with force
As a therapist with neuro traits, this can lead to flooding in me, sometimes anxiety, sometimes a shutting down of cognition as though my brain and nervous system are full.
strategies to tackle the impact of information flooding in the therapy room
When a client talks in a non-stop stream of detail about recent events in their lives, some therapists (myself included) can feel flooded - less able to focus or think, a sense of losing contact with the client, with anxiety building or a shutting-down feeling. Our ability to support the client can be compromised at these times, minimising the impact of therapy, and our own nervous systems taxed in ways that may have lasting impact. I however, find it very difficult to interrupt clients when they’re talking as it goes against a natural instinct to create space for people and prevent clients from feeling dismissed or unheard.
Phrases to pause the flood of information can include:
“Let’s pause there for a while”
“May I ask you to pause and slow this down a little?”
“Pause for a moment please. I’m feeling overwhelmed and need a little processing time”
“Let’s zoom out from this detail a little. What are you really trying to get across to me here?’
“I notice you’re giving me a lot of detail here. What are you hoping to get back from me?”
“That felt like a big statement and I want to make sure I don’t miss the weight of it.”
“I notice you’re moving quickly through this story with a lot of detail but no space to feel it. What do you think would happen if we slow down?”
"Let’s take a breath together. Your mind is moving so fast, I want to make sure your body has a chance to catch up."
The defensive narrator
We can see the rapid-fire intellectualising some clients, including some with ADHD and autism use, as an unconscious way to distance both of us from their feelings. Some clients can get to the end of a session and decide they have ‘just rambled’. Although we were trained in techniques to help clients feel so understood and accepted that they keep talking - it is our responsibility to interrupt and slow certain processes so the client can hear themselves, feel within and feel the impact of our presence.
We need to gently disrupt the defensive narrative and anchor them in immediate experience, while validating the hard work the brain is doing.
We can contract to slow the pace, gaining their permission to interrupt them regularly to summarise at a slower pace, check in on their experience in the here-and-now, offer grounding, be curious about the way they are relating to me, check they are receiving what I am trying to offer.
We can be careful in our questioning, rather than seeking clarity of details and feeding the storytelling, checking in with the impact, slowing to feel without intellectualising why or analyse.