LonePack Conversations – The Alternative Therapy Series: Animal-Assisted Therapy ft. Dr. Taylor Griffin

Someone once said that “The best therapist has fur and four legs”. Let’s find out how true that is as we explore Animal-Assisted Therapy in this episode.

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Valerie- Welcome to LonePack Conversations! I’m Valerie.

Today we’re talking to Dr. Taylor Chastain Griffin, the National Director of Animal-Assisted Interventions Advancement at Pet Partners, an organization dedicated to improving people’s health through positive interactions with therapy animals. She has a background as a dog trainer, therapy dog handler, and in mental health.

Welcome, Taylor!

Taylor- Hi! Thank you so much for having me.

Valerie-  It’s great to have you talk to us. In the introduction, I mentioned that you have a background as a therapy dog handler and also in mental health. How have you found animals positively impact human lives?

Taylor- Yes, that is a great question. I have found endless ways that animals can positively impact our lives. It’s not just in my experiences but also in research. There are so many different findings that support this claim- Animals can help us model relationships. We can learn how to trust and take care of one another interpersonally. They also help us with our physical health. There are studies that talk about us being more active when we have animals. We have more sense of motivation, a reason to get up in the morning when we have animals in our lives

There’s something intangible and indescribable about the way we tend to react when we have animals around us. When I was a counselor and I had animals in my practice with me, I found that people trusted me a lot more quickly. They would just come into the office and smile and feel comfortable because of that animal’s presence.

Valerie-  Right. Taylor, what is your relationship with animals like? As far as I know, you have a lot of dogs at home!

Taylor- Yes, my love for animals really brought me into this field. I would say that over the years, the more I’ve learnt about animals, the more I can on the perspective that they’re my teachers,- that they have something to teach me and I would just like to do all I can to be a messenger for what they bring into our lives. I see everyday when I come home that my animals greet me with love and with happiness no matter what mood that I’m in. It motivates me to try and do the same in my relationships. I have animals at home now who were rescued. They’ve had really hard starts to life and now they’re therapy animals who share love with people all over the world. I really respect animals and think they’re really complex, feeling beings that we’re only just starting to understand. It’s my goal to understand that and be a microphone for that all over the world!

Valerie-  It’s so correct that you said it’s an incomparable feeling when you go home to an animal and you get all of that love! No matter what mood you’re in, you’re always uplifted after that.

Taylor- I heard a saying once that we “should be the person our dog thinks we are” and I think that’s definitely a goal.

Valerie-  I have a T-shirt that says that!

Taylor- Great! I love it.

Valerie- Could you tell us what Animal-Assisted Therapy is? 

Taylor- Animal-Assisted Therapy is a term that falls within the umbrella term Animal-Assisted Interventions. It’s when a professional is bringing a therapy animal into practice with them to help meet treatment goals. This could be a mental health professional, a physical therapist. There are a lot of different ways that the animal can come in and help achieve those goals but it becomes Animal-Assisted Therapy when there’s measurable outcomes that relate to the interaction that we have with the animal. 

Valerie- What’s the training process like for animals to get registered as therapy animals?

Taylor- It’s an intensive process. For us at Pet Partners, we do not just register a therapy animal, we register a therapy animal team. We believe that the competency of the person is just as important as the competency of the animal because the person is going to be the one who is protecting that animal throughout the process. So if you have an animal that’s going to be a good fit, the first thing we look at is whether it’s a type of animal that’s going to actually enjoy and not just tolerate this interaction. Do they really like to be around new people? 

If that’s the case, the first step is that the human is going to take a course, we have an online course that’s available. Then once they pass that course, they can take an in-person evaluation with their animal. At that point, we’re testing fort basic obedience queues, how they’re going to respond to medical equipment, loud noises. They’re allowed to have responses, of course. We’re not looking for robots but we’re looking for whether they can recover and are still competent and happy. Therapy animals in our organization re-evaluate every two years. We know animals age much more quickly than we do so we like to make sure we’re checking in and ensuring that it’s a good fit for an animal throughout the lifetime.

Valerie- When we talk about therapy animals, what kind of animals are we talking about? How do we know what animal will have the best interaction with which person?

Taylor- We have nine different species of therapy animals at Pet Partners – dogs, cats, horses, llamas, alpacas, rabbits, guinea pigs, eats, pigs but by and large, our most common therapy animal is a dog. I always fall back on the competencies of the handler. For me, I have so much background in working with dogs that I’m definitely most comfortable interacting with therapy dogs because I can read their body language the best. 

There are different clients that have preferences. We find that older adults sometimes seem to have a preference for cats. We see that sometimes our young boys get very excited when we come in with a therapy rat. You can ask for the preferences of the people you’re visiting but really, it comes down to the animal that you’d be most comfortable working with and that’s an animal who’s going to be confident, affiliative – meaning they seek out interactions with humans, and they’re ready to listen to you so you have a safe interaction when you’re in the public. 

Valerie- What interactions do the animals have with people during Therapy? 

Taylor- That can vary depending on the treatment goals. When I was in a session with my client, they would sometimes help model healthy relationships. We would talk about how you can build trust with my therapy animals by giving them training cues or getting to know their preferences, and the same thing goes with interactions with people. You can even do physical activities- I had one activity that I did with young people. They had a ball that they could throw to play fetch with my animal and on the ball, there were maybe ten different feeling words- sad, happy, excited, and as the animal would bring the ball back to the child, they would read the word that was facing them and have to tell me about a time in their life when they were feeling those emotions. So they’re accessing these memories and emotions but in a really safe, playful way. So it really depends on the animal and on the goals of the professional but it can fit into any intervention that the professional has, as long as you’re creative and you’re committed to honoring the welfare of the animal all throughout. 

Valerie- That’s interesting! What does a typical session look like? More importantly, how comfortable does one have to be with the animal?

Taylor- The session will be different each time. When I was doing a fifty minute session, I tend to find that a client would come in, greet my animal, and sometimes we would spend time with the animal just sitting on their lap, as we talk. Sometimes, they would do about ten or fifteen minutes of training activities with them. It depends on the energy level and the preferences of the client. In order to work with a therapy animal though, you should be highly familiar with that animal. At Pet Partners, we have a rule that an animal cannot become a therapy animal until they’re a year old and the handler has had to know that animal for at least six months. We think you should have a well developed relationship with these animals so that you can read their body language, advocate for them and they’re really a partner with you in what you do, not just an accessory. 

Valerie- Supposing someone’s going to psychotherapy, when do they try something like Animal-Assisted Therapy?

Taylor- They can try it at any point in their treatment if it’s something they’re interested in and if they can find a practitioner who has a therapy animal. We consider a person to be a good candidate for this if they don’t have any fears or phobias or allergies of animals. We also like to encourage professionals to set their clients up for success by having the initial session to be one in which you just talk about how you’re going to interact with the animal instead of expectations, before having that hands-on experiences when it can become really exciting and a hard time to learn about how to interact with the animals when the animal is there. It can really fit into any time and treatment. We have animals who are with clients all throughout their process of healing, sometimes they come in every now and then as just a special treat. It’s a really flexible intervention, which is one of my favorite things about it.

Valerie- When you were talking to us earlier, you told us about how having an animal can uplift your mood and just help through the healing process. How is Animal-Assisted Therapy different from psychotherapy when it comes to sessions, in terms of the mental health impact that it has? Can you talk us through the process of healing that you were telling us about, with animals?

Taylor- Any time a therapist is going to work with an animal, there needs to be this core set of competencies. The animal is not a magic solution that brings about healing. They’re joining sides with a very skilled professional, who can meet their treatment outcomes with or without the animal. With that being said though, the animal can be a really meaningful aid. One of the things that people talk about is the idea of relationship-building, that animals assist in that and building trust between the client and the therapist. 

There are also just creative ways that you can access new things when you have an animal in the session. I’m thinking two times when we have topics that are really hard to teach young people. We would talk about consent and appropriate touch, which are hard things to communicate to a child, sometimes but when you’re modelling it on an animal like for example, I have a therapy animal named Lucy. I would tell clients that Lucy likes to be pet behind her ear and she doesn’t like to be pet so much on her stomach and so because that’s her preference, that’s something we should follow. Do you have preferences? What’s appropriate for you? So they can really model ways to set boundaries in a non-threatening way while working with the therapy animal.

Valerie- It’s so interesting that you said you can use these animals to explain things to people in a way that’s not threatening and not something that would be a confrontational conversation that would be difficult to talk about if you were doing it directly.

Taylor- Yes, exactly. You can really do a lot of perspective taking activities with animals. I would often work with children who had a hard time taking the perspective of other people but they could learn to do that with my animals. I would say that when you come into the room, it’s important not to get in Lucy’s face and be too excited because that can be overwhelming for her even though she loves you, so think about how you’re being received. Then we can put that into human context – when you walk into your classroom and behave a certain way, how might it be received by the other people in your class?

Valerie- Right. Taylor, what age groups have you found Animal-Assisted Therapy to work best with?

Taylor- Animal-Assisted Therapy can be successful across all areas of the lifespan. There’s research and anecdotal evidence to back that up. Very young children can benefit from therapy animals, and even all the way up to people with severe dementia. We even have therapy animals who assist in cases of hospice, when it’s an end of life situation. You will want to think about the size of the animal and if there are any mobility issues that will impact a person’s ability to safely interact with different sized animals but really, it’s an intervention that can be safely implemented across the lifespan.

Valerie- Okay. We’ve heard that Pet Partners is soon launching an association for professionals who aim to bring therapy animals into their work. What are your views on this? What has your experience with Animal Assisted Intervention in a professional space been like? 

Taylor- I’m very very excited about this development. For a long time, Pet Partners has focused on serving volunteers who bring therapy animals into places like hospitals, schools and nursing homes, at least in the United States. We get calls from more and more professionals across many different fields who have heard about this intervention and would like to bring a therapy animal into their practice but they don’t know how to get started. That’s what our professional association is going to help with. 

We’re going to provide that roadmap, we’re going to provide education, opportunities to connect with other professionals through an online community, we are also going to have a certification evaluation so that a professional can show that they have competencies in this area. We see this as the next step that the field really needs. At the end of almost every research paper on Animal-Assisted Therapy, you see that there’s a call for more standardization and more professionalization within the field, and that’s what we’re going to be doing through the launch of this professional association.

Valerie- That’s really interesting, Taylor!

Taylor- Yes, we’re excited. We hope to have many of the listeners today join us. It should be launching in January of 2022 and you can visit petpartners.org to sign up for a newsletter that will keep you up to date on all of our advancements in this phase. 

Valerie- Sure, thank you for giving us that information. Thank you for talking to us today about Animal-Assisted Therapy because there is so much we got to learn from you. I have a dog at home and I know just how good you can feel when you have an animal waiting for you every single time you come back regardless of how you’re feeling. You’ve also talked to us about how you can use animals to model relationships, you can mirror the feeling of trust and having a safe space in your relationships with people as well, and it gives you a sense of motivation and upliftment. Thank you for talking to us and sharing all of this information with us. It’s definitely been a very very interesting conversation.

Taylor- Absolutely. It’s my pleasure and I hope that everyone who’s listening is motivated to think about the lessons that we learn from animals, whether it be pets or therapy animals, and how we can use those lessons to make the world a better place. 
Valerie- Thank you.

Does a Rainbow Flag equal Inclusivity?

In my first year of college, we had a counsellor come to us and claim to cure bisexuality. A few events I attended after that had a rather homophobic note. To the credit of the institution, they got a new therapist and we were asked not to make “political comments during events”(at what point sexual identity became political is beyond me). In the spirit of people attaching rainbows to company logos let us see how far we have come and what we seem to have left out. 

At the risk of sounding repetitive, is the world accepting of the LGBTQIA+ community? Companies and organisations during pride month will have you think all of them are allies or actively working towards diversity and inclusion. From Google dedicating their logo to honour Frank Kameny and Linkedin adding a rainbow. But do companies want to be inclusive? Twitter has a marketing page dedicated to how the LGBTQIA+ community is a ‘market to tap into’. Is our identity just a trope and a marketing strategy? 

As disturbing as that is, we should ask ourselves what real inclusivity is.  There are multiple sources to tell you how the cause has been tainted by corporate marketing and token representation. The real struggles of inclusivity are often foreshadowed by corporates acting progressively and tricky policymakers remaining ambiguous. One such aspect not often discussed and almost never regarded as a serious problem is the availability of mental health resources for members of the LGBTQIA+ community. Studies show that despite being at a higher risk for mental health issues like anxiety and identity crises and more likely to have unmet healthcare needs, getting quality help in terms of mental health has always been a struggle for the community as a whole. 

More than half (54%) of LGBTQ youth who reported wanting mental health resources in the past year did not receive it in the United States alone. Another study in India conducted between 2009-2019 showed the prevalence of mental health concerns among LGBTQIA+ individuals in India with high concentrations reporting suicidal tendencies and severe cases of harassment. Yet another study by the Trevor Project showed that 40% of LGBTQ respondents seriously considered attempting suicide in the past twelve months. More than half of transgender and non-binary youth have also seriously considered suicide.

Studies show that even if you are lucky enough to get help, there are multiple unhelpful therapeutic practices and even discrimination based on race, creed, and income brackets, and a person belonging to multiple marginalised groups is likely to receive a lower standard of care compared to their peers. Reportedly, there has been a lack of safe spaces even with mental health professionals and cases of blatant disregard for issues faced by members of the community in India. Another crisis faced by the community is a lack of understanding, even among peers and family members. 

Now that we have highlighted the very serious and relatively-disturbing problems faced by the community, it is now time to see what we can do to make the situation better. 

  1. Try and be a good ally by educating yourself on allyship. LonePack is ready to help you!
  2. Lend your voice as an ally to the community while also being respectful and understanding of the cause.
  3. Support community-building – by members themselves and in conjunction with service providers – which is an important part of improving health for people of the LGBTQ+ community.
  4. Popularise the practice of affirmative therapy. 
  5. Reach out to and/or support organisations like the Trevor Project that aim to make quality healthcare more accessible to at-risk youth.
  6. If you need to speak with a professional, LonePack has a ‘Resources’ page with details of vetted mental health professionals who provide inclusive therapy, often at subsidised rates. 

-Neha Ramesh 

Burnout on the Frontlines

The world has been flipped upside down ever since the COVID-19 pandemic bared its fangs last year. It has swept through the world and has kept everyone gripped in its clutches to this day. Even as vaccinations are very slowly being ramped up, it does not take away from the immediate state of disarray the country is in. Mental health has taken a very big hit and it is extremely important that we address how bad things are openly and start having conversations about it. Talking about health anxieties, survivor’s guilt, and the complicated and conflicting feelings that we have to deal with in addition to trying to shield ourselves from the pandemic might pave us ways to bond over and help us support each other. 

In this article, we’re focusing on one rampantly growing phenomenon that is affecting everyone – burnout. And in particular, burnout experienced by healthcare workers and caregivers. 

Before we get to that, a quick introduction to what burnout is – burnout is not a classified medical disorder or condition but more so a phenomenon characterized by extreme mental and physical exhaustion. WHO defines it as, “…a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:

  1. feelings of energy depletion or exhaustion;
  2. increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and
  3. reduced professional efficacy” [1].

Though it is said to be most prevalent in healthcare workers, first responders and professions involved with high emotional stress, it can also affect any person in any profession. 

Here is another comprehensive guide to burnout that could also be useful. 

Now, let’s address how burnout in particular has affected our healthcare workers and caregivers. 

Burnout with healthcare workers

No amount of words can come close to the gratitude and respect we feel towards our frontline healthcare workers. This pandemic has tested them to their absolute limits and beyond, and it is no surprise at all that they are the ones taking the most of the mental brunt as well. 

In a study conducted with 2,026 healthcare workers in India, a staggering increase in burnout due to the pandemic was observed. In the 21-30 age group of respondents, the prevalence of personal, work-related, and pandemic-related burnout was around 54%, 33%, and 50%, respectively [2]. It was also observed that women had higher levels of anxiety and incidences of burnout than men. Healthcare workers also showed higher distress levels that could be attributed to the high-risk environment they work in. Nearly 55% of them were worried of contracting COVID-19, themselves and 67% were worried of carrying the infection over to their family and loved ones. 

It is of utmost importance that everyone in the healthcare field do their best to take care of themselves during these very difficult times as well. While the profession they have chosen is oftentimes a satisfying one, they also bear the most emotional and mental brunt when things, though far beyond their control, go wrong. 

Burnout amongst mental health professionals

There has been a continuous increase in the number of calls that national helplines and resource providers are receiving for mental health assistance. From domestic violence to anxiety and depression, the pandemic has exacerbated mental health issues amongst people. As most forms of counselling and therapy have moved into telehealth mode, mental health professionals are also facing great emotional turmoil as they try to help those who reach out to them. 

India, with a population of 1.3 billion people, has as little as 4000 people in the mental health space [3]. With the amount of people reaching out for help and increasing workloads,\ professionals are experiencing big stress factors to their own mental health in forms of emotional contagion and perceived stress where negative emotions can trigger the same feelings in the professionals helping them. They also are affected by compassion fatigue, secondary traumatic fatigue and the longer durations of therapy required to help people effectively [3]. 

Home caregivers

Nothing will strike fear in people as when something goes wrong with a loved one. We are all struggling with extreme loss, unimaginable amounts of pain that come with loss and the anxieties and fear that accompany seeing loved ones suffer. 

This is a wonderful and poignant article that talks about how being the primary caregiver at home takes a toll on a person’s own mental health. With most people working from home, having to shield their families and loved ones from the virus while also trying to do their best to provide for them takes an immense toll on one’s mental health. Though most workplaces do recognize the distress that their employees are facing, the economic challenges that they face forces them to keep pushing for productivity. Caregivers at home go through an equal amount of emotional and mental turmoil and we all must do our best to help both ourselves and others as much as we can. 

So how can we help ourselves and others?

Apart from depression and health anxieties, the pandemic has caused a lot of distress to people, that manifests as survivor’s guilt and post-traumatic stress. We are battling not only the pandemic but also the social, economic and cultural disparities clouded by the pandemic. Marginalized and underrepresented groups face more distress and lack policies in place to protect them as well. 

If you are experiencing burnout and are a part of any of the three groups of people discussed in this article, these can be a few practical tips that might help the most immediately that are recommended by the USA CDC

  1. Identify the symptoms of stress you might be experiencing — this can include irritation, anger, exhaustion and even insomnia among others. 
  2. Communicate with your coworkers, supervisors, and employees about job stress and talk openly about how the pandemic is affecting your work.
  3. Please do your best to reach out for mental health help when necessary and take time off if possible. 
  4. Remind yourself that everyone is in an unusual situation with limited resources.
  5. Recognize that you are performing a crucial role in fighting this pandemic and that you are doing the best you can with the resources available.

And if you, reading this article, might know someone who might be experiencing burnout, here are a few things you can do to help.

  1. Try to help them keep maintain a routine
  2. Keep talks about news, negativity and social media to a minimum and check in with them regularly. 
  3. Try to engage them in mindfulness activities that might distract them. 
  4. Make sure to remind them of their importance and appreciate all that they are doing for the world. 
  5. Try to help them get enough rest and maintain good eating habits. 

Most importantly, all of us can provide a shoulder to cry on and an ear to listen. Burnout is not something to be taken lightly and the effect it has on the physical, emotional and mental well-being of healthcare workers, mental health professionals and home caregivers can be immense. Let us all try to do our best to stand in support for them. 

This is your kind reminder to make sure to wear your mask, stay 6 feet apart from other people and to get vaccinated as soon as you can!  

Here are resources that might help

  1. LP Buddy is an online peer-to-peer support system that gives you a safe and inclusive environment to talk to trained listeners about your worries. 
  2. Mental health professionals listing platform
  3. Verified helplines 
  4. Donate to India Covid Relief

References

[1] WHO’s definition of burnout 

[2] Burnout among Healthcare Workers during COVID-19 Pandemic in India: Results of a Questionnaire-based Survey

[3] Burnout: A risk factor amongst mental health professionals during COVID-19

LonePack Conversations – The Alternative Therapy Series: Play Therapy ft. Anya Reddy

When asked to think about the significance of playing, we probably think of it as a way to help us with creative thinking, expelling our energy and social interaction. Let’s dig a little deeper on that thought today as we talk about Play Therapy.

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Valerie- Welcome to LonePack Conversations! I’m Valerie.

Today we’re talking to Anya Reddy, a Play Therapy practitioner. She is a child and adolescent psychologist who uses play as a language to help children enhance their social, emotional and behavioral skills.

Welcome, Anya!

Anya- Hi, Valerie.

Valerie-  Thank you for being here. Let’s start with you telling us how playing impacts our mental health.

Anya- Wow, well we could start with children or adults but actually to be honest with you, play is something that all mammals engage in. It starts out as our way of discovering the world, of discovering ourselves, our bodies, the things around us. As children, it’s how we develop friendships, relationships, it’s how we strengthen our bond with our parents and it’s how we foster friendships, how we discover empathy, how to share, argue and make up. As adults, it transforms. Some could say that play matures a bit, it could become teasing, flirting, it could become more organized in terms of sport. When we engage in play regardless of age, it leads to a lot of happy hormones in our body – you have oxytocin that’s releasing, it helps reduce your serotonin levels, that’s your stress. Play inherently makes your body happy.

Valerie- Right. Anya, can you tell us what Play Therapy is? How is it different from playing generally?

Anya- In Play Therapy, you have a trained licensed Play therapist who’s using play as a language to help you help yourself. The difference is that in Play Therapy, play isn’t the focus. In fact, we disregard the materials that we have because we know that the therapist is the most important tool and toy in the room. We’re using play as a language but we’re focusing on the client-therapist relationship. 

When you ask how it’s different from playing generally – when we play, there’s no goal to play whereas in Play Therapy, we have our goals. We know what we want to achieve. The child is not coming in just to play with building blocks. The way that the Play therapist holds the space, is watching the child, engaging with the child, the minimal number of rules that we have and the fact that it’s only once a week for 40 minutes, it’s very structured. Going in, even the child knows because there’s an energy in the room and the therapist is picking up on body language, energy, communication, and eye-connection. So there’s a lot that’s going on.

Valerie- Right. Anya, you were telling us that playing can help with a lot of things. It helps when it comes to discovering the world and ourselves, and getting to know ourselves better. What got you interested in providing Play Therapy professionally?

Anya- I have never been a big believer in Talk Therapy, for children especially but adults as well. I wanted to use creative methods, more artistic with movement, storytelling or mindfulness, just different techniques that would access the human subconscious. I feel like we are all able to heal ourselves and that humans are capable of responsible freedom. No one knows one’s inner world better than themselves, nobody else can tell you what you need. I am a big fan of clients being able to take charge of their own healing. So I feel like using creative methods like play allows for that. I wanted to give children the chance to blossom into human beings, not just children. 

I feel like children are infantilized. They’re almost treated as though they don’t know anything, they’re not given enough information, and are dumbed down. Then all of a sudden they’re expected to be able to handle a lot of things. We need to treat children also with respect, autonomy, dignity and just recognition for the fact that they’re also human beings who are actually very aware. A child’s intuition is much sharper than most adults’ intuition. Play Therapy allowed me to integrate creative techniques and an approach where I would be able to meet a child as a human being instead of a child as a child. I was working with a client and it had nothing to do with age. That said, you can also use Play Therapy with adults. 

Valerie- Why don’t you tell us about that? When we were talking about the impact of playing on our mental health, you did mention that it works on children and adults, and right now you did say that Play Therapy is not just for children. Why don’t you tell us more about that?

Anya- When you’re working with adults, Play Therapy is great in terms of healing the inner child. With a lot of adults, you’ll see unresolved issues, maybe a certain conditioning that’s happened, certain scars they never truly had the chance or space to fully heal, and some scars can take years to heal from. 

There’s also how you carry your childhood trauma, not only to your adult relationships at home or at work, but also into your own parenting and how it affects your parenting choices, how it affects how you feel about yourself as a parent and whether you trust yourself as a parent. I’m a big fan of using not only Play Therapy with parents but different techniques of helping parents become aware of who they’re becoming as parents, with the choices they’re making and whether they’re conscious, informed choices. 

Beyond just parents, Play Therapy is a wonderful way of connecting with the inner child, holding and recognizing how it’s important. You carry the experiences, memories, the things you learnt and regretted into who you become as an adult and along the way, we seem to drop the child in us. I feel like it’s important for us to take time out to recognize the child in us, asking ourselves what this child means, how can I help this child? After a point, you can’t really go back to your parents talking about what they did and what you need from them because they may not be able to give it to you, they may not be around. Everybody has their limitations. It’s also taking charge of your own needs and discovering that you can give yourself what you felt you were denied or what you need now. Healing the inner child allows adults to return to themselves in a way that’s empowering and sort of like holding your whole self.

Valerie- Anya, it’s so beautiful that you said you believe people are capable of helping themselves and you just need to be assisted to reach there. When you talk about Play Therapy for adults, you talk about connecting with your inner child, connecting with things that you may have left unresolved or things that you are in conflict with and this just maybe takes you back to the time that things happened and try and get them resolved and make peace with things, and that is such a beautiful thing and such an important thing for people to move on in their lives.

Anya- Right.

Valerie- Can you tell us what a Play therapy session would look like?

Anya- The beautiful thing about each Play therapy session is that they’re each so different. I have this one client, Marissa, who comes in once a week, the way she engages with the toys in the room on the surface seems the same every week but it’s the little things, and a therapist would notice how her body language has changed, whether she’s sharing her artwork with me, whether her body has turned away from me or whether she’s open to sharing space with me. I could also have a client who’s engaging with me but I have also had clients who have almost refused to engage with me. I once spent 40 minutes with a client, it was his first session, and there were no words. He just engaged in movement. It was just a lot of flapping of the arms and different moving of the body. 

So how does a typical Play therapy session look like? Well, the client knows what their boundaries are – basically keeping ourselves safe, each other safe and everything  in the room safe. If they tell me that they have hurt themselves or someone wants to hurt them, then I have to end the session and tell them in advance that I’m ending the session only because I need to keep you safe and this is something that we need to prioritize right now, and I have to tell your parent or your guardian, not to punish you but just to make sure that we can keep you safe. We have to prioritize a client’s safety before we can really even delve into the subconscious and the unconscious. It’s going to be difficult to access healing if you’re physically or mentally unsafe. 

A client comes in and they have the sand tray, they have movement, they have music, art, storytelling, mindfulness. They have a bunch of different corners and materials that they can access and work with during a session. It’s completely self-directed, meaning the client chooses what they want to do. So today they might want to do art and then next week they might want to do sand and the week after that they might do a story, and three weeks later suddenly they might want to return to the story because they’ve processed it and something finally resonates so they feel like they can finally talk about it, that there’s just something that they want to return to about that story. 

So it’s totally unpredictable in a sense, but only in a tangible sense. I suppose in the more intangible sense, I know where a client is coming from and I know where we are going, and there is a growth that I can see happening but then as a therapist, I always have to be careful that I’m not coming from a space of “I know what’s best for the client”, “I know what the client needs”, “I know how to do this”. It’s like holding clay. I’m just holding the clay and watching it as it moulds itself. 

A Play therapy session can be a client that’s throwing a ball from one wall to the other, it can be a client who doesn’t want to talk to me at all, it can be a client who just wants to sit on my lap but then we have to talk about whether that’s safe or unsafe. Then you also have to take into consideration where a child is coming from. Is this a child who has experienced bad touch? How willing am I to allow the child to use my body as a canvas to experience what good touch is? Because how can a child know bad touch from good touch if the child’s never had the chance to experience good touch? You provide a space to experience trust and affection and safety in someone whom they feel like they can experience those things with. It’s a beautiful spectrum.

Valerie- You’ve spoken to us about such a serious topic while giving us this answer. You told us that it doesn’t only delve into the kind of tools they’re playing with and trying to understand them through that but you also have to teach them so much because at the end of the day, they are children and unless they know the difference between good and bad, there’s no way for them to them to understand if something that’s happening to them is right or wrong.

How do you reach out to your clients, these children? You said some of them don’t talk to you for the entire 40 minute session. How do you reach out to them and break that wall?

Anya- Play is a child’s language and toys are their words. There’s so much therapy that’s happening even if a child isn’t playing because they are invited into a play room and they’re invited to play but they don’t have to. It’s completely their space, it’s their rules. They can say what they want, they can do what they want. What a therapist does if a child doesn’t want to engage, or even is engaging, is I hold the space. I mean that I have my eyes around them continuously for 40 minutes, I am mirroring their movement, I am completely attuned to them. When I say attunement, I mean I’m attuned to their energy, their body language, the inflection in their voices, the kind of stories they’re weaving with their toys, it’s like I’m hearing a client in more ways than one. There’s a lot of body language that’s communicated, it’s far more than words, it’s far more than play. I’m completely attuned to the sense of being like a client’s canvas. Even if they’re building a story in a sand tray, I am carrying the energy that a child leaves in a room. 

I think so much of working with children and teaching children happens in a way when you’re not really trying to. It’s sort of like you’re holding sand in your hand and you’re allowing it to do what you feel like it needs to do. You know how to keep the child safe, maybe you’re teaching the child boundaries to an extent but most of it is demonstration, and I think the biggest tool is actually empathy. When I said attunement and listening to the child in more ways than one, what it is, is empathy. I’m listening to how it feels to be in that sitting position, how it feels to jump up in a standing position, how it feels to turn your body away from me during a session and to slowly look over your shoulder at me. I’ve had that with clients. There’s just so much deep empathy in the sense that I’m almost embodying what the client is going through and that’s the deepest level of empathy and there’s no other deeper way to connect to anybody.

Valerie- Anya, thank you so much for talking to us today. For explaining to us what Play Therapy is. We’ve learnt so much from you apart from just the topic of Play Therapy. We’ve learnt that you discover the world, you discover yourselves, you discover empathy and sharing when you’re a child but when you grow into adulthood, the importance of Play Therapy could also be recognizing and nurturing the child in you and that playing can just make your body happy! What’ve we’ve learnt from you is also your personal experience, your passion to integrate creative techniques, not just talk therapy but you go on to talk about playing, art, so many other alternative means of therapy, and you interact with your clients, work on a relationship with that client so that you understand them better and most importantly, you empathize with them. As you said, that’s probably the best way to connect with somebody. Thank you so much for talking to us about Play Therapy.

Anya- My pleasure! I’m always happy to talk about it. Thanks for having me again, Valerie. 

Valerie- Thank you.

LonePack Conversations – The Alternative Therapy Series: Writing Therapy ft. Courtney Ackerman

There’s a quote by Anne Frank that goes “I can shake off everything as I write; my sorrows disappear, my courage is reborn.”

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Valerie-  Welcome to LonePack Conversations! I’m Valerie.

Today we’re discussing Writing Therapy with Courtney Ackerman, a researcher, the author of three published books on positive psychology-related topics, and a regular contributor to the Positive Psychology program. In her independent work, she mostly focuses on compassion, well-being, and survey research.

Hey, Courtney!

Courtney- Hi, Valerie. Thank you so much for having me.

Valerie- Thank you. Why don’t you start by telling us how writing has an impact on our mental health?

Courtney- Absolutely. It’s a big question because there are tons of positive impacts of writing on our health. Not only do we sort of get to know ourselves better but we get to understand the world around us and other people better. When we start to write down our thoughts and feelings, it helps us process them, get a hold of them and work through them in a way that we normally don’t, if we don’t write it down or discuss them or investigate them with curiosity. Writing can help with a ton of different things. 

Just a few of the research findings have shown that it leads to better health outcomes in terms of lower blood pressure, improvement in lung function, reductions in symptoms in all different kinds of illness, better immune system functioning, even improvements in things like anxiety and depression and substance abuse, eating disorders and post traumatic stress. On top of all that, it gives you those really great insights about yourself, it helps you get shifts in your perspective that can help you interact with yourself and with the world around you, which can result in better relationships, both with yourself and with the people around you. It might be quicker to answer “What doesn’t writing help you with?”!

Valerie-  Right. Could you tell us what Writing Therapy is and how it compares to conventional Psychotherapy?

Courtney- Writing Therapy is just another form of therapy. Just like all the other forms, it’s something that’s focused on the client’s mental and emotional well-being. It’s focused on healing and so it’s got the same usual goals of improving the client’s functioning and helping them with their problems and helping them feel better. It’s sort of a typical working relationship between the client and the therapist but the difference with Writing Therapy is that it’s very focused on journaling, on writing. 

It’s sometimes also called “Expressive Disclosure” or “Expressive Writing”, which I really like because it focuses on what you’re doing, when you’re doing Writing Therapy, and that’s not just writing anything but you’re writing expressively. You’re expressing yourself, you’re diving into things that are difficult or things that are going on in your head. It allows you to express and exercise those negative emotions to get things off your chest. Just that act of writing down your thoughts and feelings can help you process them in a much simpler and more straightforward way. It helps you to identify what it is that’s wrong so that you can then work on it with a qualified mental health professional.

Valerie- When you were telling us about this, you did mention that Writing Therapy is all about expressing your thoughts through the way you write and gaining a better insight on your surroundings. Is there a significant difference between Writing Therapy and journaling?

Courtney- There is a difference. They are very related and of course one can complement the other but there are a few major differences between Writing Therapy and journaling. The first one is that Writing Therapy is led by a licensed mental health professional so you can do all the journaling you like on your own and that can be really great but Writing Therapy in particular is when that process is guided by someone who has been trained and is licensed in this arena and can help you with exercises and prompts and ideas and can help you work through the things that you’ve written down, so there’s that component that’s different. 

Another difference between Writing Therapy and journaling is that journaling is usually sort of off the cuff. You write about what happened in your day and what you’re feeling. Therapeutic writing is more directed- it’s usually guided by prompts or exercises. It;s not necessarily free-form where you write about whatever you’d like. It’s more guided. Third, journaling is more about what happened in your day and how you’re feeling about that while Writing Therapy is actually engaging with your thoughts and feelings. Not necessarily recording them or responding to events that are happening in your life but actually diving deep, thinking about and analysing your own thoughts and feelings. It’s this sort of meta activity where you’re thinking about thinking and you’re feeling about feeling, and you’re really diving in on a deeper level than most people usually do when they journal. 

Valerie-  Right. So journaling would basically be an outlet to your thoughts and a way for you to express yourself through that whereas Writing Therapy might be engaging with your thoughts and analysing it and trying to understand what you feel. Is that right?

Courtney- Right, exactly. You can journal however you like so usually some people would journal in this way but generally, people just sort of journal writing about what happened in their day, what they think about it, what they’re looking forward to. Writing Therapy would be more like – this thing happened, these are the thoughts that occurred after, this is why I think I’m having these thoughts, this is what I feel about having these thoughts, it’s just sort of peeling back a layer, getting a little bit deeper into engaging with those thoughts and those feelings that you’re having. 

Valerie- Courtney, what got you interested in writing and journaling, and authoring three published books?

Courtney- You know, actually that number is upto five! My fifth came out in December. Clearly I’m a fan of writing, I like writing a lot. I’ve actually always really liked writing but for a long time, I never really did it regularly and I never really sat down with an intention for myself. Of course you sit down with an intention to write papers and to write books or articles but I never really sat down and wrote with an intention for myself, just sort of writing for me. When I discovered that this is sort of a way of doing things and that there are a lot of Writing Therapy exercises and things you can do in that arena, it really resonated with me. It helped me let go of these things that I was holding down to, things that are frustrating or difficult or negative, the things that can weigh you down. I found that writing them down was the best way for me personally, to let them go. 

For me, journaling is an excellent way to relieve stress, an excellent way to get those thoughts and feelings down, to let go of the more negative or unpleasant ones, or to sort of record the more positive ones. I don’t just journal about the negatives, I also jurnal about what’s going right, what’s great in my life, what I’m grateful for. It makes it feel more real when it’s down on paper. It’s such an excellent way of dealing with your thoughts and feelings. When it’s in your head, it’s all a big jumble. When you write it down, things can start to make a lot more sense. One of my favourite things about journaling as a mental health activity is that there are virtually no barriers to entry. If you can write, you can have a direct active role in your own healing. You don’t need anything else. If you have paper and a pen, you can journal!

Valerie- It’s so wonderful that you found writing to be a way for you to let go of things that you’ve been holding onto and the things that have been weighing you down, and you took that personal experience, knowing that it works for you, to write books to help people as well. You wrote books on positive psychology and I think that’s wonderful, taking an experience and using it to help people. 

Courtney- Thank you. When you find something that works for you, you want to share it with people. That’s my goal. If even one person finds my books and enjoys the exercises or the techniques in there or finds them useful, then it was totally worth it. I’m a helper! I like to help people So whenever I find something that really works for me, I wonder who else this could work for, I wonder who else this could help, and I try to find a way to get it down on paper and get it out to people.

Valerie- You did mention when you talked about Writing Therapy, that it’s something that’s usually prompted. It’s not free form writing. What I wanted to ask you is that are there different types of writing practices under therapy that help give an outlet to one’s emotions or what they’re feeling? 

Courtney- Absolutely. There are a lot of different techniques and you’d sort of have to dive into the different exercises and prompts and techniques out there in Writing Therapy but some of the main ones are writing about traumatic or stressful events. That’s used a lot for people with Post Traumatic Stress Disorder or any kind of reaction to a stressful event. It doesn’t necessarily need to be diagnosed PTSD to help you deal with stress but that’s one of the most common things that you’ll find. You’ll be guided to write about the stressful or traumatic experience that you suffered, and kind of work through it, process through it, work with a qualified mental health professional to process it, and it can help make the whole experience a little bit less salient, a little bit less impactful on you today. The more that you go through it and write about it in a safe space, the less impact it has on your day to day life. So that’s a pretty common exercise for people in Writing Therapy. 

There are tons of different techniques to follow thoughts, deconstruct them. Say you’re dealing with low self-esteem and you’re not feeling great about yourself. Writing Therapy might help you figure out one particular reason that you’re not feeling good about yourself. Maybe feeling like “I’m not successful”. Then it’ll help you walk back from that thought, all the way to the core. So you’ll start with “I’m not successful”, and then you’ll ask “Why does that matter?” Then you’ll walk back to thinking “There’s this rule that you must be successful to be happy.” Then you’ll ask yourself, “Well, do you really need to be successful to be happy?” And so it’s this step by step process where you’re following a thought or a feeling all the way back to a core belief and then figuring out whether you like that core belief. Whether that’s something that you want to hold onto, whether it’s helping you or hurting you, and if it’s hurting you then create a new one in its place. Instead of “You must be successful to be happy”, it can be “I deserve to be happy now, whether I’m successful or not”.

Valerie- That’s actually really interesting, that you would work backwards from something as simple as a sentence and then you’d use that to introspect and see whether what’s being said in the world is something that you actually believe or whether it’s something that works for you. It’s such a beautiful way that something can help you. You start with something so small and you can end up in learning so much about yourself.

Courtney- Absolutely. That’s why I love it too. It gives you tools to really dive in because we all have these core beliefs but if you ask someone on the street what their core beliefs are, they’re probably not going to be able to say much. When you sit with your thoughts and write them down, and ask yourself questions and introspect, this stuff comes up. There’s pretty much nobody out there that has a set of beliefs that have completely been analysed or agreed with, without any issues. We all have those core beliefs we are unsure of, that come from our parents or society, that maybe we don’t like or believe anymore and you don’t really think about those core beliefs until you start writing them down and engaging with them.

Valerie- True. Courtney, what’s a simple way to get started? Does one need to have a flair for writing to try out Writing Therapy or journaling?

Courtney- Absolute not! You do not need to be a writer to write in a journal. Like I said earlier, one of my favorite things about journaling and Writing Therapy is that you don’t need anything in particular. You don’t need any skills. As long as you can write, you can engage in this kind of stuff. It’s best to engage with a professional if you want to do actual directed Writing Therapy but there are definitely tons of steps that you can take on your own and a lot of my books are focused on that. There are exercises that you can do on your own, at home or at work or wherever you are, and just dive into this stuff. There’s one easy acronym that I really like, to get started and it’s the WRITE method, that comes from Cathleen Adams at the Centre for Journal Therapy. She’s brilliant, you should go check out that website if you want to know more. As an easy way to get started, think WRITE:

W – What do you want to write about? Name it, label it. Give it a name. 

R- Review or reflect on it. Write it down and just think about it, toss it around, feel it out. Reflect on this thing that you want to write about.

I – Investigate your thoughts and feelings. You start writing and you just keep writing, and approach it with curiosity. Approach it as if you’re a researcher, researching your own thoughts and feelings. Get curious and ask questions and keep writing. 

T – Timer. Use a timer, set it from anywhere between two minutes to thirty minutes, and then just keep writing until the timer goes off. Usually people think that ten minutes is a lot and before they know it, the time is gone!

E – Exit the journaling session by re-reading what you’ve written after that timer goes off and then just reflect on it with one or two sentences. You may reflect on it by saying “Wow! I had a lot more to write about than I thought. It’s interesting that this came up”. Just closing it out by looking at what you’ve written and giving it a little summary.

Valerie- It’s so nice that you said that at the end of it, after you start writing and you reflect on it and you set a timer and you keep writing, at the end of it you sit down and reflect on what you’ve written, you see what you can take away from it. You don’t just write and let it be, it’s a way of understanding yourself better so you sit with it, you understand what you’ve written and where you can go from there. I think that’s such a good thing to do and such a good thing to put into practice. 

Courtney- Right. I totally agree. Usually when we journal, we don’t usually re-read what we’ve written. We kind of journal, close the book and put it away and maybe open it the next day and journal again, which is great but taking that time to review it at the end and to really think about it, that’s what takes it to a next level.

Valerie- Makes sense. Courtney, thank you so much for talking to us today about Writing Therapy. We’ve learnt so much from you and gained a better insight into what Writing Therapy is. We’ve learnt that we get to know ourselves better, we get to know the world around us better, and we can just sit and engage with our thoughts and express ourselves in a way that whatever we feel in weighing us down or something we’re holding onto, we can exercise releasing those negative emotions. Thank you for letting us know that and for the work you do when it comes to writing and psychology and positivity.

Courtney- Thank you! And you’re welcome. I’m happy to do it. I’m happy that people are engaging with these subjects. It’s really exciting.


Valerie- Thank you so much. 

Representation of Neurodivergence in Media

“If you’ve met one person with Autism, you’ve met one person with Autism” 

This is a common saying when talking about Autism Spectrum Disorder (ASD), precisely the reason why it’s known to be a spectrum; different people experience the symptoms in different ways. But when it comes to the media, movies and tv shows, is it represented the way it should be? 

Imagine the last time you saw a character with Autism in a movie or tv show, it could be the character of Shaun Murphy on ‘The Good Doctor’, Sam Gardner on ‘Atypical’, or even Sheldon Cooper on ‘The Big Bang Theory’ (although the writers have never confirmed it). Now, most people would think that this is amazing, that having positive representations of Autism would be a good thing, but is it really?

The answer is neither in black nor white.

When we first think about Autism, we think of characters who are socially awkward, avoid eye contact, maybe are hypersensitive to stimuli, but at the same time are all geniuses in their field. However, only around 10% of people with autism have Savant abilities. Every person on the spectrum experiences it differently, some might be verbal, some non-verbal; some might be able to mask their symptoms well, while some might not. It doesn’t reduce the impact that Autism has on their lives. And the problem is, while one side of it is represented, calling for stories and dramatization, a whole other side of it isn’t. 

Even though Sheldon is never confirmed to be Autistic, why does everyone categorize him as being on the spectrum? Why do we think so, when it is not really accurate? Well, for most people, exposure to Autism comes only from the media and we associate the stereotypes portrayed in the media with our belief systems about Autism. The more number of times a character is portrayed with the above-mentioned attributes, the more these beliefs are strengthened and voila! People now have a fixed perception about Autism.

While media representation can help end stigma and can lead to a positive attitude about Autism, it can also have negative effects, such as propagating stereotypes and inaccuracies.

Yes, this might not be a deliberate move, but in the whole process, it can make people who, “Don’t look like they have Autism”, difficult to access services and care, when in reality, they might just be better at masking the difficulties that they have. This causes them a lot of stress and anxiety. Even parents may ignore symptoms that their child has, just because they don’t display these stereotypical behaviours. This becomes a classic case of, ‘good intention, bad execution’ and, ‘negative effect’.

So what can be done? Do we stop portraying neurodivergent characters altogether?

Well, no. First things first, film makers and scriptwriters must talk to the people that they want to represent; those on the spectrum. The neurodivergent community has been asking for accurate representation for a very long time, and according to them, neurotypical (individuals who do not have a diagnosis of Autism or any other developmental disorder) actors portraying neurodivergent traits reduces something so complex, nuanced, and beautiful, into a trait that anyone can imitate on screen, which isn’t the right thing to do. Also, if we look closely, there are close to no female characters with Autism being represented. This is a result of a deeper phenomenon (Our article coming out next week, explores this in greater detail.)

The argument that might rise is, ‘Hey, isn’t it only acting?’ 

Yes, but it must be kept in mind that while the community is having positive representation in the media, they are still being portrayed through a neurotypical lens. They are also constantly being left out of opportunities and underrepresented in real life. Disability has a 2% representation rate in the popular media, and out of that tiny figure, only 5% of disabled characters are played by disabled actors.  So in the long run, isn’t this doing more harm than good?

Filmmakers and scriptwriters must understand the responsibility that they have and the impact that their films can make, and realize that having large audiences that watch them having a neurodivergent character just for the sake of token diversity and comic relief, won’t work.  Stories need not be dramatic but that doesn’t mean that everything must be an educational booklet about Autism. Creativity in human beings is limitless and beyond boundaries, and the right stories can definitely be told in the way that they deserve to be.                                                       

LonePack Conversations- The Alternative Therapy Series: Bibliotherapy ft. Bijal Shah

While reading a book or a quote, have you ever felt like it best put into words exactly what you’re feeling? That’s the power of literature – it offers us a connection and intimacy that is unique to the medium.

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Valerie – Welcome to LonePack Conversations! I’m Valerie.

Today we’ll be exploring bibliotherapy with Bijal Shah, a bibliotherapist, counsellor, author and poet. She is the founder of Book Therapy – a book curation service that offers bibliotherapy, literary curation, personalized reading services and bibliotherapy training. 

Hey, Bijal!

Bijal – Hey, Valerie. How are you?

Valerie –  I’m doing well. It’s so great to be talking to you today.

Bijal –  Thank you, it’s such a pleasure to be here!

Valerie –  Could you tell us how reading books helps with mental wellness? 

Bijal –  Sure. I often see literature as a mirror, as a tool that reflects what we’re feeling because when we read, we read through our own lens. We filter things out through our own experiences. It’s a great self awareness tool and I’d say that the power lies in the relationship that’s formed between a reader and writing, whether that’s narrative or poetry or essay, and the reflections of the thoughts, feelings or observations that the writing provokes. I always suggest a daily journaling practice, capturing exactly what the literature is bringing out for us, so you’re using books as a prompt and that can be used as a self-care structure to you or it can be in your counselling or psychotherapy sessions or whichever mental health professional you’re working with. Books can really help facilitate any sort of mental health struggle that you’re going through, help you process your feelings, find coping strategies and just help to process emotions and release those because that’s so important that reading should help express, and books essentially act as a medium for that. 

Valerie –  When you were talking about this, you told us that one aspect of reading that stands out is that you’re reading through your own lens – it’s your narrative and about what you pick up from a book that you’re reading. You talk about journaling, you talk about how you prefer that someone journals or take the help of a mental health counselor, while reading.

Taking up on that, what is Bibliotherapy? How does it work as an alternative form of mental health therapy? 

Bijal – Sure. Here at Book Therapy, we pretty much define Bibliotherapy as a form of Art Therapy that focuses on the power of stories to heal, so really leveraging off literature to process emotions, using it as a prompt for self-awareness and connection. The basis of Bibliotherapy is essentially two-fold: It focuses on the ability of the Bibliotherapist or mental health professional to prescribe the right text for each individual as there’s no size that fits all, so it depends on the reader’s personal preference. It’s also imperative that the reader is willing to explore the value of literary thinking and seeking meaning within the literary language through self-reflection and journaling and/or discussion with a trained therapist or counsellor. 

In terms of the actual Bibliotherapy process, there are essentially three stages to it – 

The first stage is that the reader should identify and connect with the text or the character, if it’s fiction. The text itself needs to help the reader connect with the emotions and allow them to process it. This is what I call a cathartic response. Also, literature should provide insight into the individual’s own situation based on the issues faced by the character or discussed in the text. Thirdly, allow the reader to consolidate their learnings and lessons in a therapeutic fashion. I would say that those are the three stages of Bibliotherapy and you could use those as self-prescription or in a session with a counsellor or therapist. 

Sessions span both fictional and non-fictional literature, across a variety of mediums. You could read novels or poetry or tragedies or essays – all of these things connect with us in different ways and the actual magic happens in that process of reading and the interpretation and reflection because it’s all being framed from the perspective of the reader and this is where you start to work with what the literature is bringing up for them. 

Valerie –  Bijal, you were telling us about the magic of literature. What’s your relationship with books like? 

Bijal –  I grew up in Nairobi, Kenya so I spent a lot of my childhood and teenage years there and there was only one community library or book store but I found myself hanging out there a lot. I’ve always found it a source of comfort and solace. Living in Nairobi was very much like living in lockdown like we are right now! So in terms of entertainment, there’s not a lot and you find yourself doing a lot of reading the whole time. I’ve always found books very comforting and healing, and I never really picked up on the concept of Bibliotherapy until I was in my own counselling training and I had to see a therapist as a part of that. These were weekly sessions and I found that in between, you might have all sorts of issues or things going on as you’re waiting to see the therapist and it’s in that space in time that I felt like literature really anchored and supported me because I could reflect on what I was feeling. I felt like literature was really allowing me to leverage therapy outside of my therapy sessions. 

Valerie –  What was the inspiration behind founding Book Therapy and making this personalized curation service for people?

Bijal – There’s been a lot of research going on over the years by University students and PhD students and whilst there’s a lot of research, it’s never really hit the mainstream market and lots of counsellors and therapists do prescribe literature as a part of their sessions. What I wanted to do was really focus on Bibliotherapy itself and bring all my learnings together. I really just wanted to bring together everything that we need in terms of techniques and tools to use literature, and that could be like creative writing, unstructured writing.

Reading and writing really go hand-in-hand. You’re reading but you’ve also got to do a bit of reflection and that normally comes from writing. If you’re averse to that then you can record a voice note to yourself! That’s what I call audio journaling and it’s also very important to get those feelings out and express the things that you’re going through and capture them and that is healing in itself. A lot of the work that I do involves reading and then writing. Reading for fun is great but if you want to also use it as a therapeutic tool, then this is how you can make the most out of your reading.

I felt a real urge to bring what I had learnt through my training and my own personal experience with literature to other people and that’s when I actually launched Book Therapy. I found that sometimes you want the Bibliotherapy sessions but sometimes you just want a prescribed reading list so I would also curate reading lists based on what people tell me they’re looking for. I do it for therapy but I also do it for personal interest because I have people telling me they’re avid readers and ask me to prescribe something to them. I now have this feedback loop of what’s working, what’s not and it helps me hopefully tailor something that can be really useful and valuable to my clients.

Valerie –  It’s so nice that you’ve said that when someone’s going through something, you’re providing them a service by prescribing them books that might help them express or understand what they’re going through better. It’s such a great service that you’re doing for people.

Bijal – Thank you! Similar to what LonePack’s doing, it’s creating ways of helping people find ways to cope when they’re going through difficult times. Especially now during the Pandemic, people are really struggling with mental health and sometimes it’s not easy to get access to a counsellor. Sometimes it’s hard to find a counsellor that you connect with. I think we have books and literature that offers us a lot of choice and variety, and it’s still a form of connection. It’s not connection with a person but you’re connecting with something, with a character or with the author, and it’s really satisfying our human need for connection because a lot of issues start when you’re feeling disconnected with either parts of yourself or with others. So it’s really sort of bridging that gap and I always say that it’s a form of meditation, especially if you’re reading mindfully, it’s giving your brain a break, mental space to breathe!

Valerie –  How have you found Bibliotherapy play a role in youth mental health in particular?

Bijal – When I think of youth mental health, there are two branches – there’s children’s Bibliotherapy and then there’s teenage Bibliotherapy, and I think each is quite different. Children’s Bibliotherapy is sometimes more complicated because children are young and they don’t always have a language to express what they’re feeling but picture books and Play Therapy can be hugely helpful in helping children express themselves and also process what they’re going through because children really need us to help them regulate their emotions and they need to learn how to do that. Literature and Play Therapy are such wonderful ways to teach them how to do that. 

During the teenage years, literature is very much a developmental tool so I call it developmental Bibliotherapy where they’re learning about the world through literature because there are so many things that are never really touched upon in class. For example, you might get taught about sex education to know how someone becomes pregnant but you don’t talk about the other things around that like actually exploring your sexuality or your needs. None of that is addressed in a classroom. I think literature can be a way to help you explore your identity, help you explore your sexual needs, beyond just the basic things that you’re told. I really think that developmental Bibliotherapy can really help people with that. Even if it’s cognitive and social development, being assertive, dealing with anxiety, all of these things are actually important lessons for teenagers which are not often focused on, in the academic setting. I think mental health literature is just the perfect bridge. Also, I don’t see many youth going to see counselors whereas I do see lots of people read. Teenage is the time where you actually get to read before you go to University where you just stop reading. We should help teenagers make the most of this time in developmental Bibliotherapy, and that could also include a lot of young-adult literature.

Valerie –  Bijal, you’ve given us an insight into how reading books can impact our mental health. You’ve told us what Bibliotherapy is. Can you now tell us the steps of how one can develop a good reading habit and include literature as a part of one’s self-care?

Bijal – I probably want to leave you with a few things that I think are super helpful. Practice mindful reading. Sure, reading for escapism is fine and there’s a place and space where you need to do that but if you’re reading from a therapeutic perspective, practice mindful reading. Ask questions about what the literature is doing for you, what feelings it’s bringing out, is there something that it’s nudging or prompting? Create an intention habit, a consistent time to read every day. Reading is like going to the gym. If you don’t do it everyday, you’re just going to be a holiday reader. If you want to get out of that holiday reader mode, you have to do it daily and create a space where you do it, like a designated reading space because all of these things bring consistency and consistency helps you build that into your daily routine. I’d also say keep a book journal. Every time you’re reading, write about it. Reflect on what it’s doing for you. I would also say find an accountability partner, a reading partner. Someone you read with or you could be reading the same book at your own time but coming together to discuss it because that is what’s going to get you reading and finishing the book. I’ve found that when you have a reading partner, you’re more likely to be committed to it, similar to a book club. I would say all of those things are great in terms of building better reading habits. 

Valerie – That’s so nice. Bijal, is journaling something you do regularly? In everything that you’ve talked about, when you speak about reading, you always also added the importance of journaling and how it enhances the whole reading process.

Bijal – Absolutely, yes. I do it pretty much every day. I’m always writing something because I love writing! Whether it’s quickly jotting down a poem or writing down how I’m feeling that way or something that I’ve noticed about myself, I will just write that down and that just immediately creates a sense of relief because I feel like I’ve taken it out of myself and I’ve put it on paper. It’s really cathartic and healing, I can’t recommend it enough. 

Valerie – Bijal, thank you so much for talking to us today and giving us an insight into what Bibliotherapy is. We’ve learnt from you that books can be comforting and healing. We’ve learnt that we read books so that we can connect with the text and through the text, we can connect with characters, connect with your own emotions, dig into something and realise and identify things that maybe you were not comfortable with when it comes to your own self. That you can take those learnings and consolidate them. We’ve also learnt that there are different forms of literature that can help us best connect with our emotions. Thank you for the tips that you gave us on how we can use reading personally and develop reading habits in order to take care of ourselves and develop our mental wellbeing. Thank you so much.

Bijal – Thank you, Valerie. It’s been such a pleasure to be here and I do hope that it’s helpful and that it helps somebody in a meaningful way. I think that’s the best reward for this.

Valerie – Thank you, Bijal.

Myths vs Facts about Autism

Myth: “Autism is a disease”

Autism is a neurodevelopment disorder– a disorder in brain function, affecting one’s emotions, communication, learning ability, and self-control. It doesn’t “spread” like a disease.  It develops as an individual grows. The whole concept of disease/illness cannot be applied here. Autism is treated to help support emotional growth and communication, and is not “cured”.

Myth: “Everybody with autism is either non-verbal or savant.”

The more extreme (and especially rare) cases of people with autism are popularized, leading people to believe that ALL people with autism have either extraordinary skills or poor levels of understanding.

Though Autism Spectrum Disorders (ASDs) are characterized by unique patterns in social interaction and repetitive/restricted patterns in behavior; it is important to note that these characteristics vary in terms of severity and impact. For example, speech impairments can range from deficits in understanding to complete lack of speech. Several adults diagnosed with ASDs can live independently, while others can’t. The savant skill is a condition wherein a person with autism has an exceptional mental ability. However, this condition is rare and its degree varies as well. People with autism who show a particular interest or exhibit a particular skill set are often confused for having the savant skill, which need not be the case. 

Myth: “Vaccines cause autism.”

This myth started with a research paper published in the 1990s, that linked vaccines with ASDs. However, the research paper wasn’t credible at all, and the medical professional had his license taken away. The myth has still stuck around to this day and contributes to the number of anti-vaxxers. A vaccine has no relation to autism; it only boosts your immunity and resistance against particular diseases. 

Myth: “The number of people with autism has increased/ There is an autism epidemic going on”

Around 1 in 68 children are diagnosed with autism. This number is significantly higher than it was two decades ago. The only reason for this is that the awareness of ASDs began to increase in the 1980s-1990s. With this increase in awareness, more people were able to identify the signs of autism. Hence, more individuals got diagnosed. Apart from this, the definition of the word, ‘autism’ was expanded to be more inclusive of the variety of unique cases falling under the autism spectrum.

Myth: “People with autism are treated so that they can ‘resemble neurotypical people’ ”

Autism is a lifelong disorder. Methods that heavily intervene in a child’s life at an early age to “make” them neurotypical(like a few cases of Applied Behaviour Analysis, which requires being under supervision for 20+ hours per week.), tend to affect the child’s mental health negatively. Convincing a child that they need to be ‘fixed’ can lead to trauma and life-long anxiety. As Barry Pratz said, this mindset and these methods ‘treat the person as a problem to be solved rather than an individual to be understood’. Instead, allowing the person with autism to be in a comfortable environment, and understanding the reason behind any particular speech/behavioral pattern of theirs can help them remain safe.

Myth: “Autism is a case of over-diagnosis.”

Several researchers also argue that changing the criteria for autism and making it more inclusive, has led to an over-diagnosis of the condition.

Rather than it being a case of over-diagnosis, milder symptoms that are associated with behavioral challenges are being recognized and accepted under the autism spectrum. This helps to prevent further serious ailments that could occur as a result.

Myth: “Autism itself is a myth.”

In Lorna Wing’s concept behind the autism spectrum, she mentions that the autism spectrum “shades imperceptibly into eccentric normality“. This implies, that behavioral habits exhibited by people with autism are also exhibited by people without autism. 

‘While people with autism self-stimulate, neurotypical people fidget. While people with autism have certain things they are sensitive to, neurotypical people have dislikes and preferences.’  

While there may not be a well-defined line around the criteria for being included in the autism spectrum, there most certainly is a difference between neurotypical individuals and individuals with autism.

People with autism are diagnosed with ASDs. The core features of ASDs are trouble with social communication and inflexible repetitive behavior. Neurotypical people are not diagnosed with ASDs, or their symptoms do not fall under the category of the autism spectrum. 

The similarities between people with autism and neurotypical people aren’t enough to debunk a disorder that affects all aspects of life for those who are diagnosed with it. Especially now that more people are aware of ASDs, people with mild symptoms are also diagnosed with autism.

As put rightly by Steve Silberman, “It wasn’t long ago that someone who spoke to his or her friends by typing on a keyboard was considered severely handicapped. Now they’re just a teenager.

Sources:

health.clevelandclinic.org

otsimo.com/en/

www.kennedykrieger.org/

www.onecentralhealth.com.au/

www.healthline.com/health-news/are-we-over-diagnosing-autism#Criteria-changes

www.ted.com/talks/wendy_chung_autism_what_we_know_and_what_we_don_t_know_yet?

LonePack Conversations- The Alternative Therapy Series: Narrative Therapy ft. David Newman

When you’re asked questions like “What’s your story?”, what’s the first thing that comes to mind? Today let’s take time to realise the importance of the stories we tell ourselves, and others, while talking about our lives.

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Valerie – Welcome to LonePack Conversations! I’m Valerie.

We’re in conversation with Narrative Therapist, David Newman. He has an independent counselling practice through Sydney Narrative Therapy, works at a psychiatric unit for young people, and is a faculty member of the Adelaide based Dulwich centre, one of the homes of narrative therapy and community work.

Hey, David!

David – Hi, Valerie. It’s nice to be here.

Valerie – Thank you for agreeing to talk to us. Let’s start with you telling us what narrative therapy is and how it relates to and aids our mental health.

David –Well, in short Narrative Therapy is an approach to therapy and community work. It’s something that social workers and psychiatrists and psychologists and nurses will do in their work, when they’re doing counselling work or therapeutic work. But if I just go back just a tiny little bit, Narrative Therapy found some of its understandings through the cognitive revolution and the idea that we are meaning-making and thinking people, the human race, and that one of the ways that we make sense of things or make meaning is through the lens of a narrative, that in order to be able to make sense of things, we need to have the lens and it’s through the lens of a narrative. So that’s where some of the ideas and the impetus of Narrative Therapy came from and these go back in time to probably about the 1950s in terms of what was happening in psychological theory at the time. 

Now Narrative Therapy is an idea that you might say comes from a post-structuralist understanding that is about the plurality of life and about the inconsistencies and the contradictions in life and in identity and one way that that’s taken up in narrative practice is to say that life is always multi-storied, so as a narrative practitioner, we’d always be assuming that someone is not just the problem story, they’re not just a bundle of despair or anxiety or panic, but there’s also other glimpses of life that are outside of those stories and the narrative practitioner is wanting to breathe life into those glimpses, when people aren’t being able to cope or take action in life. 

Life is multi-storied but Narrative Therapy also contextualizes it. Identity is seen as a contextual and social achievement. In other words, we are really interested in looking at what happens around people so you might call it a sociological approach or analysis to the shaping of stories. What that means in terms of Narrative Therapy practices is that broadly speaking, the first thing you might say about Narrative Therapy is that it looks at the context of people’s lives and not the problem with people, so it does what we call “externalizing the problem”. Externalizing the problem is imagining and speaking or writing or drawing, or whatever it might be, as if the problem stories are separate from people. So people are in a relationship to despair, people are in a relationship to a suicidal experience, people are in a  relationship to addiction or conflict, or whatever the problem might be. That’s called externalizing and that’s a big part of the conversation. 

The second thing to say about Narrative Therapy practice would be that when we find an aspect of life outside of the externalised problem story, we really want to ask a lot of questions and be very curious and listen out for stories that can be built on, like stories of coping, stories of skills of living.

Valerie – That’s really interesting. You look at it from a perspective of knowing that life is multi-storied and that you don’t just look at the problems but you try to look at it in context to your life and then try to work around that.

David – Yeah, that’s right.

Valerie –  Personally, what is it that got you interested in narrative therapy?

David – So Narrative Therapy, for me, is not just critique. Narrative Therapy is certainly critique and is responding to some of the politics of psychology and counselling and therapy and community work at the time, in the 80s and late 80s but it wasn’t just critique, it was also practice. So seeing in these ideas a strong engagement with power, a strong engagement with issues of culture and a non-pathologizing stance but there were full of very very elegant practices. Very elegant and very effective practices. So it was both a critique mixed with practice and I was really drawn to that.

The other thing that drew me to Narrative Therapy was that it is very non-individualistic. It was about connecting people and joining people around similar experiences including joining people with their own communities. So therapy or community work wasn’t sort of cut off from life so much, the world of the person was brought into therapeutic process much more than I’d seen in other approaches.

Finally, I was really drawn to the way that Narrative Therapy engaged with personal story, the personal story of the therapist. Around the time in the 70s and 80s, there was quite a lot of pathologizing of what was considered sometimes problematic motive for why people would get engaged with therapy – that they had something often that would be spoken of as an unmet need and in Narrative Therapy, there was an engagement with personal story that would be acknowledging and honoring a personal story as shaping of purposes that you brought to the work – that because you know something about how hard life can get as a therapist, you want to bring that kind of purpose to the work because maybe if you know a little but about what it’s like to have a parent who has an alcohol problem, you’ll bring that determination to do something about it and have skills around what you can do around those experiences, that you can bring to the work. So it’s engaging with their personal story in a way that was acknowledging and honoring, rather than pathologizing and dismissing.

Valerie –  It’s beautiful that would help somebody with their personal problems and personal story in a way that you engage with them as opposed to stigmatizing it, and then you help them through that in a way that you’re also concerned because you can connect it to something from your own personal life.

David – Yeah. So for instance, one practice of Narrative Therapy would be to let people know, let couples or families or individuals know that you have been taken somewhere else in your life as a result of the conversation, you have other ideas for your life as a result of the conversation or as a result of the work. You know that as a result of hearing how determined this person is to listen better to their child, that you will take that with you too in your parenting or something like that. So yes, there are particular practices where we let people know how we’ve been moved somewhere else as a result of the conversation. Typically in Narrative Therapy, this is an aspect of re-telling someone’s story, it’s honoring or acknowledging re-telling a story when we tell them how someone’s story has taken us.

Valerie –  Yes. David, what age groups have you found narrative therapy impact the most and what are the different ways through which people can tell their stories? 

David – I would say that because Narrative Therapy really engages with meaning-making, that’s what it’s interested in and the meaning-making lens as I said earlier, that is privileged in narrative practices is storytelling, I would say anybody at any age can take part in these conversations and in this work. I would say for children who are very young, there might be some limitations in terms of language but I would say even from as young as 3 or 4, I think, children can use language to describe their experience in ways that we can shape a therapeutic conversation of sorts. I think the limitations to the age is not so much the age of someone, it’s the limitations of the workup and the extent to which they’re bringing particular practices and ways of talking that are resonant for the person, they’re a part of the person’s culture, they’re a part of the person’s way of doing things, or style. 

In terms of how stories can be told, I think it can be not just about the spoken word, and quite often therapists will ask people to draw a picture of their worries or a picture of depression. That’s a way that we can engage with meaning-making or some sort of communication. There’s also ways that therapists have been exploring music, and that’s another option. There has been a huge explosion of using metaphors as well in Narrative Therapy, so we bring a metaphor that might be resonant, often the metaphor of the tree of life and how people might use a tree as a metaphor to speak about their lives – the roots are where you’ve come from, etc. and that’s another way that we can tell stories. This is another more recent development over the last ten years of how metaphors are being richly engaged in telling stories as it has lots of advantages including that people can speak indirectly about experiences which can help enormously when people have had a traumatic experience and it’s very hard to speak about it directly.

Valerie – David, can you give us a further insight into what happens in a Narrative Therapy session? How does a narrative therapist understand people and help them through their problems?

David – I think something that’s reasonably common to many approaches to therapy and community work is that the narrative therapist is really interested in the experience of someone. They really want to get a rich sense of the experience of someone. Narrative Therapy is very interested in using and reflecting back the language that someone uses. In fact, Narrative Therapy would take a position against re-wording what someone says and representing it through a professional expert kind of language or psychiatric language. It would be about trying to use the language that people bring. Someone might speak about way out thoughts or dire thoughts as opposed to for instance the psychiatric term that gets imposed sometimes as “suicidal ideation”. 

A Narrative Therapist is listening out for a problem story and how they are being described, and the effects of the problem story. So if someone did speak about dire thoughts, we would be asking about the effects of the dire thoughts, what the dire thoughts might be saying, what gives the dire thoughts power,  the context through which the dire thoughts might be getting a lot of power but we understand, because life is multi-storied, we understand that there are always glimpses of life, often they’re in the shadows of the problem story but there are always glimpses of life outside of the problem story and the narrative therapist is always listening out for those glimpses and trying to take note of them, listening carefully for them. 

So we’re listening for the problem story and we’re listening for glimpses outside of the problem story, which in Narrative Therapy, we call alternative stories or preferred stories, sometimes they’re also referred to as second storis or subjugated stories, and we want to breathe life into those other stories and help them come out of the shadows of the problem story.

Valerie –  Is it possible for people to find their stories through the stories of others’ lives, or while playing a role in someone else’s life?

David – I have been very interested in the idea of people finding their stories through the stories of others’. For the last eight or so years, I’ve been working part time at a psychiatric unit for young people in Sydney, and I do many many groups. In these groups, one thing I’ve noticed is that people will often find their own language and their own experience, when they hear someone else’s experience. I might be doing a round in a group and the opening question might be “What’s something that’s rough for you?”. Someone might say “I really don’t know” and then we’ll go through a few people answering what they think is rough for them and then all of a sudden someone who didn’t know how to describe just how rough things are and how to describe the turmoil will find words for it. They’ll find words because they realise that there’s an overlap of an experience or story with someone else, or the opposite – they’ll know that that story or experience does not speak to them, and in that sense, they’ve got a sense of what does speak to them. They have a sense of a little bit of what their story is

This concept of people finding their stories from the stories of others’, I’ve found incredibly helpful in work because it means I put much less pressure on people to speak because they’ll speak once they hear something either of their own experiences reflected in others or not reflected in others. I also use this very much with the written word. These alternative or preferred stories, in Narrative Therapy, there’s a long tradition of writing down these stories so people can have them when they go, or that they can donate these stories to other people who are going down a similar path. We share these stories later or documents in the group so that people get a sense of their own stories through the stories that have been written down. So that’s one thing that I’ve found very very helpful.

Valerie – David, thank you so much for talking to us about Narrative Therapy. There is so much that we got to learn from you today, getting a better insight into what Narrative Therapy is. We learnt that it’s about meaning making and making sense of things through the lens of a narrative. We learnt that life is always multi-storied and you look at the glimpses of life outside your problems. That is such a beautiful thing, that you connect with experiences, you connect people with experiences and you can also relate to other people’s experiences to form your own narrative and find your story through that. Thank you so much for talking to us about Narrative Therapy today.

David – My pleasure, Valerie. I hope it was of use.

Valerie – Thank you.

Understanding Autism Spectrum Disorder

What is ASD?

Autism Spectrum Disorder, or just ‘Autism’ as it is referred to commonly, is a neurological disorder that is known to cause social, communication, and behavioral challenges in the development of an individual. It is known as a ‘spectrum’ disorder because the people affected experience a wide range of symptoms, each of them unique in severity. 

People with Autism often need a lot of help navigating day-to-day life, but the degree of help required varies depending upon how well the individual is able to balance their disorder and life. 

They usually do not look any different from those who are unaffected; the only tell-tales are in the way they behave and interact with others. However, it is important to remember that they are full human beings with valid feelings, too, which should be acknowledged and respected.

What are the signs and symptoms to look out for?

Children and adults with Autism face difficulty in social situations, especially when it comes to communicating what they want to say. They also have trouble conveying their emotions, and tend to avoid human interaction altogether due to this. 

Some common signs that individuals with Autism display include:

  • In children: Delay in learning to speak
  • Inability to create or hold eye contact
  • Hypersensitivity or Hyposensitivity to sensory stimuli
  • Have difficulty in reading others’ gestures and intentions
  • Often want to be alone
  • Have trouble relating to others or forming connections
  • Repeat their motor movements
  • Have very rigid thinking patterns
  • Shy away from human touch
  • Avoid talking about their feelings
  • Have trouble adjusting to changes in routine
  • Repeat certain words and/or phrases: Echolalia

However, people with Autism are also more often than not, extremely talented in other non-routine activities. This is called the Savant Syndrome. 

For example, there might be someone who can’t concentrate in Mathematics class, but can do 1359357 x 1359357 in his mind at the drop of a pin. There might be someone who could replicate the Mona Lisa, but would not be able to smile at societally-dictated occasions. Darold Traffert, famous psychiatrist, has extensively studied this syndrome, and suggests that, ‘savant skills may result from the formation of exceptional neural structures during prenatal brain development.’ While there is controversial evidence mounting against the study of this syndrome, evidence suggests that there is a strong genetic link between family members displaying similar talents. 

It is extremely vital that we treat them just as we would treat anyone else, and not differentiate based on ability. 

What are the causes of ASD?

We do not know all the causes of ASD, but we do know that there are predominantly genetic and biological factors involved, such as:

  • Taking certain medicines meant for epilepsy and cancer during pregnancy, such as valproic acid and thalidomide
  • Children born to older parents are at higher risk
  • Children with a sibling with ASD are also likely to inherit ASD
  • Individuals with certain genetic or chromosomal conditions, such as tuberous sclerosis, can have a greater chance of having it
  • Children with very low birth weight are also at risk

ASD occurs among all racial, ethnic, and blood groups, but it has been found that it is 4 times more common among boys than in girls. 

How can we diagnose and treat ASD?

Since there is no blood or other medical test that can diagnose ASD, doctors have to look at a child’s early behaviour and development to make a diagnosis. 

Another problem with ASD is that it takes a longer time to diagnose, which means that children don’t get the early help that they require. There is also no known cure as such for ASD. However, research shows that early intervention in the form of helping children learn essential skills such as walking, talking, basic speech therapy, etc. 

While learning these skills can make a child feel extremely self-conscious and unsure, it is crucial to a child’s development, and it is important to ensure that the child receives it at the right stage. 

How can we be more empathetic towards people with Autism?

It is human nature to fear and discriminate against that which we don’t understand. The same is the case with respect to people with Autism. It is sad because they are often subjected to derogatory and hurtful name-calling such as ‘retard’ and ‘dork’, when in reality they’re just as human as everyone else. It would be very upsetting for any ‘normal’ person to listen to such things, so imagine how it would feel for those extremely talented people who have been misunderstood all their lives. 

So how can we be more empathetic towards such individuals?

As a parent, encourage the talents of your child. 

As a teacher, be vigilant and identify the signs and symptoms as early as possible. 

As a friend, make sure the person isn’t left out in whatever you do together.

As a decent human being, be more accepting.

Remember, Autism is just an illness that a person has. The person is not the illness, themself.