It Isn’t You—The Kids Are Just Mentally Unwell

Parents, therapists, educators—I say this with so much love in my heart. You are trying your goddamn hardest. And yes, being burnt out and disillusioned and complacent still counts as trying your hardest. The same systems and structures that made all of you so sick, so burnt out, is making our neurodivergent kids so sick and burnt out. Things have been bad for a while, but the COVID-19 Pandemic was really the final straw that broke the camel’s back.

You know all those neurodiversity-affirming supports and strategies for regulation? It isn’t that if you just did it a certain way, the neurodivergent kids would be able to self-regulate. It isn’t that if you just took the next professional development or the master class, the neurodivergent kids would be able to generalize a coping skill. You’ve tried it all. I know. I’ve tried it all too.

And here comes the part where I bring up myself. My own personal experience. It relates—I promise. I need to mention it, at least briefly, because it has profoundly impacted how I clinically practice, how I talk to team members, and how I provide professional developments. I will discuss it plainly. Depersonalized. Just present facts.

A lot of my life I was mentally unwell. And then I went on extended medical leave. I got better. So better, in fact, that I am feeling emotions I haven’t experienced since I was in elementary school. My nervous system literally healed and is still healing.

I am learning new skills. I am doing that thing where I can remain somewhat calm and reflect on a difficult situation. I can pause and table some thoughts because I know that those thoughts aren’t benefitting me right now. I can look back at what I have been able to do and feel proud and have the confidence to try new things. I can practice restraint in how I respond to sudden triggers. And I can look back at what I have been able to accomplish and feel comforted by that, even in difficult times. Sometimes these things are harder than other times, and sometimes I can’t do these things. But now I know I have the ability to do these things, and it took me being mentally ok for me to be able to do them.

And I bring this up because, god damn. My experience of being autistic has fundamentally changed, and so my conceptualization of autism and how an autistic person can feel and live has fundamentally changed.

These strategies—the deciphering bodily cues, the reflection on feelings in the present verus other situations, the vary many types of emotion and regulatory-strategy visual aides—the reason these skills don’t seem to build on each other significantly over a long term is because they are presently inaccessible. They are good strategies and supports, and they can work under the right conditions. But presently they are inaccessible because our neurodivergent kids are mentally unwell.

And I need to be careful here. I do not want to make the mistake that I have made in the past—assuming that every autistic person’s experience is just like mine. That’s not true. Of course not every autistic or ADHD child we are seeing for services is mentally unwell. I can’t make an absolute statement. But by the time they have an IEP, they are usually seeing us because there is some sort of problem.

You want to know why that one autistic kid is just steamrolling through peoples conversations? Even in the autistic-only social group? Even when told its important to hear everyone out? Even when providers attempt to bring in some self-awareness to this child?

How about why that the hypervigilant anxious autistic kid who has been in counseling for years and seems to be unable to use meaningful strategies when the same or new difficulties arise?

Or why that autistic kid seems to be taking some sort of pleasure in inappropriately provoking others?

Or why that autistic kid is ruminating, looping looping looping on one subject and unable to move past it?

It isn’t you—the kids are just mentally unwell. That’s it. And you might be thinking “jeez, well a lot of the kids on my caseload act like that—but it’s just the autism.” It’s not the autism. Or the ADHD. It’s that your caseload of kids is mentally unwell.

I used to not understand this. I didn’t understand that sometimes what you get when you stop pressuring a mentally unwell autistic person to mask is a mentally unwell autistic person who has permission to display crisis. They are now outwardly in crisis as opposed to inwardly in crisis, but they are misunderstanding autistic demonstrations of that crisis as an inherent part of their identity.

I have had the pleasure of seeing several happy healthy autistic kids as clients. I also know several happy autistic kids of autistic friends of mine. The common thread connecting them, me, you, us….is having a sustained period of time of feeling safe and secure. Then we help build resiliency. Then we model strategies. Then we problem-solve.

And sometimes that sustained period of feeling safe and secure won’t come for a while. It could also be inaccessible—for a variety of reasons. But in the meantime…what the heck do we do?

Let’s take that autistic kid who steamrolls through what others are saying and has little self-awareness and is generally agreed upon to be annoying because they are actually doing something that even the most patient of people would find annoying. The anxious kind of annoying.

Social skills curriculums still aren’t the answer—they fundamentally can't help this child understand that everybody's ideas should be heard. Neither can SEL curriculums. The child isn't at a mental place to learn this skill. To sit and feel impatient and tolerate that discomfort of impatience. What we do is going to depend on a number of factors. Things like the kid's age, the team members, the values of the parents, administrative pushes towards data-driven "progress," the kid's history of trauma and the nature of that trauma, etc.

Then we clinically problem-solve this complex situation. We analyze it as a team and come up with ideas. And that can feel hard, and we can feel impatient because we want quick solutions too. But we need to be honest with what is going on here, and we need to come together as a team. We gotta slow down and think to help our clients slow down and think.

We need to treat ourselves compassionately to be able to treat our clients compassionately.

And here comes the part where I plug my and V Tisi’s course. In Let’s UNMASC: Understanding Needs and Motivations of Autistic Social Communication, V and I walk clinicians through how to do the clinical problem-solving of complex situations. The teamwork. The self-compassion. We go through it all. Check it out.