The AuDHD Psych Podcast

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🎙️ Episode 26: Understanding Neurodivergence - More Than Diagnosis
"I can be autistic without autism spectrum disorder, in the same way that I can have legs without being broken."
Summary:
In this episode of The AuDHD Psych Podcast, clinical psychologist and AuDHDer Aaron Howearth takes on a question sparked by a challenge on social media: can you identify as autistic without holding a formal diagnosis of Autism Spectrum Disorder? The answer is yes — and in this episode, Aaron unpacks exactly why, drawing on clinical definitions, diagnostic criteria, the neurodiversity-affirming paradigm, and his own lived experience as an autistic ADHDer and former Navy serviceperson.
Aaron begins by untangling three terms that are often conflated: neurodiversity, neurodivergent, and diagnosis. He explains that neurodiversity — like biodiversity — simply refers to the natural range of cognitive styles that exist across humans, while neurodivergent describes a brain that functions differently from the neurotypical majority. Autism, he argues, is a cluster of cognitive characteristics — not a disorder by default. Autism Spectrum Disorder, on the other hand, is the diagnostic label that applies only when those characteristics cause functional difficulties in the person's life.
Drawing on Damian Milton's Double Empathy Problem, Aaron explores how social and communicative differences in autism are not inherent deficits, but mismatches between communication styles — a dialect problem, not a language problem. He walks through how the same characteristic (say, cognitive rigidity or impulsivity) can function as both a strength and a barrier depending on the environment, using vivid examples from his own clinical work and time in the Navy.
Aaron also addresses the claim that autism diagnosis is "not a social construct," offering a clinical and philosophical unpacking of what a social construct actually is — and why diagnosis, by its very nature, fits that definition. He closes by emphasising that a neurodiversity-affirming perspective does not deny difficulty; it contextualises it. A person's expression of their characteristics as strengths or challenges will always interact with physical health, social inclusion, life stress, and environment.
Key Themes & Takeaways
Neurodiversity vs Neurodivergent vs Diagnosis — Why these three terms are distinct, and why conflating them creates confusion about identity, language, and clinical need.
Autism vs Autism Spectrum Disorder — Autism refers to a profile of cognitive characteristics; ASD is diagnosed only when those characteristics cause functional difficulties.
Diagnosis as Social Construct — A clinical and philosophical explanation of why all diagnostic frameworks, including ASD, are socially constructed — and why that doesn't undermine their validity or usefulness.
The Double Empathy Problem — Milton's framework explaining that autistic communication difficulties emerge from mismatch, not from inherent deficit; neurotypical people experience the same difficulty in autistic-majority environments.
Valence-Neutral Characteristics — Every autistic or ADHD characteristic is contextually neutral: the same trait can be adaptive in one environment and a barrier in another.
Cognitive Bandwidth & Masking — How the implicit effort of operating in a neurotypical world consumes cognitive resources, raising baseline stress and reducing capacity for flexibility.
Formulation Thinking — Why a neurodiversity-affirming lens requires us to account for the interaction between characteristics and everything else in a person's life: sleep, health, social safety, and stress.
Referenced Concepts
DSM-5 diagnostic criteria for Autism Spectrum Disorder
Damian Milton's Double Empathy Problem
The neurodiversity-affirming paradigm
Social and relational models of disability
We are different, not defective.
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Keywords: AuDHD podcast, autism and ADHD, neurodivergent psychologist, neurodiversity affirming, Howearth Psychology, queer psychologist, autism diagnosis, ADHD awareness, lived experience, neurodivergent mental health, clinical psychology podcast

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 🎙️ Episode 25: AuDHD Experience - Neurodiversity-Affirming Practice

"Neurodiversity-affirming practice" is now on almost every clinician's website here in Australia and around the world — but what does it actually mean, and what should it look like in the room? In this episode, Aaron Howearth (Clinical Psychologist) unpacks affirming practice not as a marketing label, but as a genuine reorientation of how we understand, formulate, and work alongside neurodivergent people.
We start with the conceptual foundations: relocating difficulty away from the individual and into the mismatch between a person and an environment that demands they be someone they're not. From there we walk through the domains where affirming practice actually shows up — formulation, language, collaborative goal-setting, therapeutic-style fit, and environmental adaptation — using the five Ps formulation and plenty of lived-experience examples along the way. We then name clearly what affirming practice is not: relabelling old deficit-focused work, abandoning clinical reasoning, avoiding difficulty, or imposing an affirming frame on someone who hasn't asked for it.
Finally, we offer six practical markers you can use to tell whether the care you're giving or receiving is genuinely affirming — and an honest note on where the evidence base currently sits. As always, this is general educational information, not individualised therapy or advice.

In This Episode (Chapters)

(00:00) Welcome and why affirming practice matters
(01:30) What the research tells us — and where the evidence base is thin
(03:00) Affirming practice as a reorientation, not a new treatment model
(04:30) Relocating disability: the environmental mismatch
(06:00) What we're actually trying to do in therapy (and what we're not)
(08:00) The domains of affirming practice: formulation, language, goals, adaptation
(09:30) Identity-first vs person-first language
(10:30) The five Ps formulation, worked through as a personal example
(15:00) Building treatment plans that align with the client's goals
(18:00) Why suppressing natural ways of being costs us — masking, burnout, safety
(20:30) Adapting the therapy itself: the person–therapy fit and homework
(24:00) What is NOT neurodiversity-affirming practice
(28:00) Six markers of affirming care
(34:00) Outcomes: quality of life, not typicality
(36:00) A closing reflection and an honest note on the evidence

Key Takeaways

Affirming practice changes the work, not just the words. It's a reorientation of perspective, not a rebrand of deficit-focused therapy.
Difficulty is relocated into the mismatch between a person and an environment that expects them to be different — not into the person themselves.
The goal of therapy is a life that has value to the client and meets their goals, not normalising someone for what society expects.
It is collaborative and consent-based: language, goals, and adaptations are co-designed, never imposed.
It does not abandon clinical reasoning, the evidence base, or honesty — it holds those alongside genuine respect for the person.
Homework that isn't getting done is a design problem to be barrier-managed, not a motivation failure.
Six markers of affirming care: formulation names the environment; goals are client-led; goals don't ask for unhelpful masking; adaptations are individualised; language preference is asked, not assumed; outcomes are measured by quality of life.

A Note on the Evidence

Much of what's discussed today draws on lived-experience research and correlational data rather than randomised controlled trials. We don't yet have affirming interventions rated as evidence-based across systematic reviews — but the parallels with affirming practice in trans and queer communities, alongside strong lived-experience data, point clearly in this direction.

Disclaimer

This episode is general educational information only. It is not individualised or tailored therapy, assessment, or support. If you need support, please seek out an affirming clinician in your area.
Thanks for listening, and remember — we are different, not defective. 
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Keywords: AuDHD podcast, autism and ADHD, neurodivergent psychologist, neurodiversity affirming, Howearth Psychology, queer psychologist, autism diagnosis, ADHD awareness, lived experience, neurodivergent mental health, clinical psychology podcast

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🎙️ Episode 24: AuDHD Experience - Late Diagnosis and Identity Reconstruction
"After a lifetime of feeling wrong, broken, like a weirdo, along comes late diagnosis — but that's the doorway, not the destination."
In this episode of AuDHD Psych, Aaron explores late diagnosis and identity reconstruction for autistic, ADHD and AuDHD people — why so many of us are found so late, and how we rebuild a sense of self afterwards. Drawing on the research and his own experience, he unpacks why late diagnosis is the norm rather than a personal failing, how internalising presentations and masking keep us under the radar, and why our diagnostic criteria, built around externalising behaviour, miss so many of us for decades. He looks at the double feeling of diagnosis — relief and grief arriving together — and at diagnosis as something that confirms who we already were rather than changing us. He also handles the borderline personality disorder pathway carefully, as a frequent misdiagnosis and conceptual overlap rather than a relabelling, while naming the stigma that does real harm.
Takeaways:
Late diagnosis is the norm, not the exception — being missed for years is what the research predicts, not evidence that you were ever fine. You weren't missed because you're not neurodivergent; you were missed because you didn't present the way the criteria expected.
Our diagnostic criteria were built around externalising presentations in academic and clinical settings, creating an observation bias — so people who internalise, the author included, fly under the radar until the science catches up with the lived experience.
Masking hides our characteristics, and higher masking predicts later diagnosis — the more we mask, the less we show up against the criteria. That same effort drains the cognitive and emotional energy we need for daily life, pushing us toward burnout, overwhelm, anxiety and, for some, depression and self-harm risk.
Masking carries a heavier cost where we're raised to be "socially acceptable," which is part of why we talk about masculine and feminine presentations when we really mean externalising and internalising ones.
Many neurodivergent people — particularly those raised as girls — receive a borderline personality disorder diagnosis before autism, ADHD or AuDHD. The two can genuinely coexist, but it is often a missed or mistaken identification, and the unfair stigma attached to BPD others people even further and makes things worse.
Late diagnosis is frequently cathartic and a relief, and at the same time brings grief for what could have been and anger at having been called lazy, chaotic, "too much" or "not enough." Holding relief and grief together is not contradictory — it's the normal shape of finding out late.
Diagnosis or self-identification doesn't change us; it gives us a framework to understand ourselves through that isn't only deficit-based. Compared against a neurodivergent frame, the "typical" person would look deficient too — it's difference, not defect.
Identity reconstruction is gradual, not instant — we reconfigure our sense of self over time, find ourselves reflected in community, and integrate our emotional history, coming to see our characteristics as a source of strengths as well as struggles.
Reflect on a characteristic you associate with deficit — say impulsivity — and look for where it has actually served you: a leap that brought adventure, curiosity that fed creativity or research, pattern recognition that made you brilliant with systems. A balanced, true view of yourself is the foundation for rebuilding who you are.
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Keywords: AuDHD podcast, autism and ADHD, neurodivergent psychologist, neurodiversity affirming, Howearth Psychology, queer psychologist, autism diagnosis, ADHD awareness, lived experience, neurodivergent mental health, clinical psychology podcast

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🎙 Episode 23: AuDHD Experience - Joy, Strengths and Quality of Life
"Strengths-based framings sit alongside, not instead of, our support needs — so keep both ideas in mind."
In this episode of AuDHD Psych, Aaron explores joy, strengths, and quality of life for AuDHDers — moving past both the deficit-and-disorder framing and the neurodivergent-superpower narrative to find the partial truth in each. Drawing on recent research, he unpacks the strengths autistic and ADHD people endorse (pattern recognition, hyperfocus, humour, creativity), how flow, hyperfocus, and monotropism overlap, and why our strengths are linked to well-being when we name and use them. He also looks at what genuinely lifts quality of life — affirming relationships, good environmental fit, support, and community — while warning against environments that extract our strengths without supporting our needs.
Takeaways:
Neither the deficit-and-disorder framing nor the superpower narrative is the full truth — strengths-based framings sit alongside, not instead of, our support needs.
Research backs the strengths neurodivergent people describe: autistic strengths like pattern recognition, detail orientation, systematising, deep expertise, and a justice orientation; ADHD strengths like hyperfocus, humour, and creativity, endorsed well above the typical community.
Strengths are linked to well-being — first by knowing and naming them, then by using them in your life. ADHD creativity and divergent thinking are also linked to real-world achievement and even deliberate mind-wandering.
Flow, hyperfocus, and monotropism share much of the same terrain — feeling good in the doing and getting to unmask — but it's a dose-response curve: restorative up to a point, then a driver of burnout.
Monotropism appears to be transdiagnostic, scoring above the general population in both autistic people and ADHDers, and underpins special interests as a well-being variable.
Autistic adults score lower across all four WHO well-being domains, with autistic women carrying a disproportionate burden — but employment, support, and relationships are concrete, observable improvers.
Quality over quantity: a few reciprocal, accepting, affirming relationships support well-being far more than many social contacts. A positive autistic identity, mediated by external acceptance and community, also lifts quality of life.
Much of the "disorder" we diagnose reflects a mismatch between person and environment, not an inherent flaw — Milton's double empathy problem reframes communication "deficits" as differences that dissolve in affirming spaces.
Beware extraction: environments that benefit from your strengths without supporting your difficulties are a structural problem requiring a structural fix — environmental, cognitive, sensory, and social accommodations.
Reflect on three of your own neurodivergent strengths and where you apply them, and seek out environments and community where you can unmask and feel safe — joy and well-being are real, and joy is a variable of well-being.
Keywords:
AuDHD, neurodivergent strengths, joy, quality of life, monotropism, hyperfocus, flow, well-being, special interests, double empathy problem, environmental fit, burnout, affirming community, different not defective
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Keywords: AuDHD podcast, autism and ADHD, neurodivergent psychologist, neurodiversity affirming, Howearth Psychology, queer psychologist, autism diagnosis, ADHD awareness, lived experience, neurodivergent mental health, clinical psychology podcast

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⚠️ Content note: This episode discusses suicide and suicidal thoughts directly and at length. It is general education, not personal advice. If this feels like a lot, please pause and reach out to a support service (Australian helplines listed at the end).
Episode 22: AuDHD Experience – Suicidality & Protective Factors
In this episode of the AuDHD Psych Podcast, clinical psychologist Aaron Howearth explores why suicidality risk is higher in neurodivergent communities — and why that risk is not inherent to being autistic, ADHD, or AuDHD. Drawing on clinical work, lived experience, and recent research, Aaron is clear that elevated risk is an outcome of the interaction between neurodivergent people and environments that don't accommodate them. The through-line of the whole conversation: we are different, not defective, and it's not your fault.
Aaron unpacks the mechanisms behind heightened risk — constant masking leading to defeat and entrapment, thwarted belonging and a sense of burdensomeness, isolation and minority stress, and unmet support needs. He then turns to crisis care and affirming support, with a direct message to clinicians about flat affect, sensory-hostile environments, and the difference between autism, ADHD, AuDHD and trauma. The episode closes on hope: the protective factors and practical safety-planning scripts that can genuinely reduce risk.
Key Themes & Takeaways
Risk Is Real, Not Inherent – Suicidality is elevated in neurodivergent communities, but it reflects environmental mismatch and accumulated stress, not a flaw in the person.
Masking → Defeat → Entrapment – Constant camouflaging is exhausting and, when reinforced over time, can drive feelings of defeat and entrapment.
Belonging & Burdensomeness – Thwarted belonging and a sense of being "a burden" can heighten risk, especially alongside complex trauma histories.
Isolation & Minority Stress – Social exclusion, sensory load, and the extra stresses of being a disempowered group compound over time.
Crisis Care Can Fail Us – Flat affect being misread and sensory-hostile crisis settings can drive disengagement from support.
Affirming Care Matters – Sensory and communication accommodations, and directly asking about risk, help people feel safe enough to engage.
Protective Factors – Positive childhood experiences, community and belonging, unmasking, and sensory fit all reduce risk.
Safety Planning Works – Make a safety plan while you're well, with someone you trust — it's yours, and it can change over time. Includes scripts for clients and clinicians.
If you need support: 
 · Suicide Call Back Service 1300 659 467
 · 13YARN (for Aboriginal & Torres Strait Islander people) 13 92 76.
 · QLife (LGBTIQ+ peer support) 1800 184 527.
 · Lifeline 13 11 14
 · Beyond Blue 1300 22 4636

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Keywords: AuDHD podcast, autism and ADHD, neurodivergent psychologist, neurodiversity affirming, Howearth Psychology, queer psychologist, autism diagnosis, ADHD awareness, lived experience, neurodivergent mental health, clinical psychology podcast