Episode 22
Why Affirming Occupational Therapy Matters for Autistic and ADHD Adults
What if everything you think you know about occupational therapy (OT) is… not quite right?
Here’s a confession: until recently, I thought OT was just glorified PT for your arms. Someone stands you up, hands you a toothbrush, checks a box, and off you go back to life, hopefully less miserable.
Turns out, that’s not even close.
In this episode of Different, not Broken, I, Lauren Howard (aka L2), sit down with the very person responsible for blowing up everything I thought I knew: Jayna Niblock. She leads our OT efforts and, frankly, if there’s ever a Hall of Fame for affirming neurodivergent care, her (sensory-friendly, weighted) cape deserves to be on display.
Let’s hit pause on everything you’ve heard about adult autism care. Because what actually happens after an adult diagnosis? Not much, honestly. There’s a chasm—no bridge, barely a ladder—between finally knowing you’re not “broken” and actually figuring out how to live as yourself in a world designed for, well, not you.
Spoiler: the aftercare programs that support adults who’ve lived decades masking, muddling through social scripts, wondering why life feels like pushing a boulder up Mount Neurotypical, do not exist. (Except now, they kind of do, and Jayna’s at the center of it.)
But what is OT for adults, especially for neurodivergent adults? It’s not about workplace “occupations,” and it’s definitely not just “PT from the waist up.” We talk about what “affirming” OT truly means—because trust us, not all therapy is created equal. We break down how “meaningful engagement” is radically more important (and therapeutic) than any checklist. Cookies, margaritas, grandkid snuggles—sometimes the route to healing starts with the things people actually care about, not the ones prescribed by someone who just met you.
Jayna gets real about why so much of the OT world hasn’t caught up to neurodivergent realities, and what an education (not treatment) program can unlock for adults desperate for answers after a lifetime of feeling “othered.” Plus: why most information out there (hello, TikTok) is validating but not always actually, you know, evidence-based.
And then there’s the stuff NO ONE TELLS YOU about sensory processing as an adult. Like why your eyes work in mysterious ways even after every eye doctor swears you’re “fine.” Or why “touch” isn’t just about what fabric you like, and brushing your teeth means something different for everyone.
We also get into the messy, beautiful, lifeline-level importance of consent, motivation, and adapting “therapy” to what matters for real people, not just what looks good on an insurance form. (Hint: if getting up in the morning for yoga is torture, you’re allowed to say no. Here, consent isn’t optional, it’s foundational.)
Maybe you’re wondering: why should YOU listen?
Listen if you were ever told you’re “normal now”—but it sure doesn’t feel like it. Listen if you believe neurodivergent adults deserve more than DIY diagnosis and crowdsourced therapy from social media. Listen if you want to know what care could actually be when it’s crafted for us, by us, with us. Listen if you want to hear two humans occasionally tearing up because, yeah, dignity in healthcare shouldn’t be this rare.
You’ll walk away with a radically new understanding of OT, equipped with ideas, hope, and probably a newfound appreciation for doing things your way—whether that’s baking cookies, mixing a margarita, or advocating for yourself in a doctor’s office full of “experts” who still haven’t figured it out.
No spoilers, but don’t miss Jayna’s answer to “if you could snap your fingers and create the OT system every neurodivergent adult should have…” (We’re not crying, you’re crying.)
Different, not Broken is for everyone who’s spent a lifetime feeling like the system wasn’t built for them—because, newsflash, it wasn’t. And we’re here to change that.
Come for the myth-busting. Stay for the life-changing “aha.” And if someone ever tries to tell you recovery only happens on their terms? Send them our way. We’ll have cookies—and probably a few margaritas—waiting.
Transcript
We're talking specifically about the people who have been traversing the world
Speaker:to the best of their ability, trying to appear normal for their
Speaker:entire lives and then find out that they were
Speaker:normal. And, like, we've made cookies. Because, again,
Speaker:that was something that was meaningful for someone to then pass out
Speaker:to other people who lived in the facility or, like, with their grandkids.
Speaker:I always knew that it was gonna rewire people's brains about how they think about
Speaker:themselves. When you take away all meaningful engagement for people,
Speaker:how that doesn't help them physically or mentally get better.
Speaker:All right, here we go. I'm gonna pretend I'm pushing record, because that feels right.
Speaker:Okay, I'm pressing record. Boop. Hi,
Speaker:everybody. I'm Lauren Howard. I go by L2. Yes,
Speaker:you can call me L2. Everybody does. It's a long story. It's actually not that
Speaker:long a story, but we'll save it for another time. Welcome to Different
Speaker:Not Broken, which is our podcast on exactly that.
Speaker:That there are a lot of people in this world walking around feeling broken, and
Speaker:the reality is you're just different. And that's
Speaker:today. I have a very special guest with us. I can't wait to spend a
Speaker:little bit of time talking about her area of expertise, because we
Speaker:are so lucky to not only have her with us today, but also
Speaker:as a huge partner within lb. And she's helping us build out
Speaker:some things for autistic adults that literally don't exist
Speaker:elsewhere. And I could just sit and stare adoringly and
Speaker:listening to her talk for hours. So I figured, like, why not? Today we have
Speaker:the person who leads our occupational therapy efforts, Jayna Kneeblock, who
Speaker:is here with us. She's an incredible occupational therapist. Well, thank you for that.
Speaker:I feel like that might have been overdone, but I still appreciate it. It's
Speaker:never overdone. I am a multiply neurodivergent
Speaker:ot and with my own host of
Speaker:sensory things that I didn't understand until
Speaker:I got to become an OT and kind of dive into this
Speaker:sensory world. And fortunately for me, the people I was
Speaker:learning from were very affirming
Speaker:before. That was really kind of conceptualized the way that it is
Speaker:today. I didn't realize kind of at the time that the reason
Speaker:I loved it so much was because of the way that it was affirming. Because
Speaker:I've now come to understand there's a lot of ways that it's done that is
Speaker:not affirming. And so when we're
Speaker:looking for making sure that, you know, someone is Paired
Speaker:with an OT that's affirming, or when you and I are talking, it's how do
Speaker:we help people create meaning out of their experiences,
Speaker:Bringing that to just kind of the foundation of what
Speaker:affirming OT should look like. It's not about changing the
Speaker:way that we process things, but it's about understanding why
Speaker:and then using our interests and our strengths to be
Speaker:able to maximize our capabilities and allow
Speaker:that creativity that also comes out of being
Speaker:neurodivergent to like, fully form in our brains as our
Speaker:idea and then come to fruition. You know, me randomly
Speaker:reaching out to you and being like, I have an idea. People shit on
Speaker:LinkedIn all the time. And I get it. Like, it's got a reputation of being
Speaker:a really, really cringy place for cringy people to talk about how
Speaker:their dog taught them about B2B sales. I get that. However,
Speaker:that has not actually been my experience. In fact,
Speaker:that's actually how we met and how we moved in the direction of
Speaker:building these things that. I'm not being dramatic when I say these
Speaker:things don't exist. There is no
Speaker:consistent available programming for
Speaker:autistic adults, and in a lot of cases, ADHD adults. If you're talking
Speaker:about some of the neural complexities that I know that you deal with
Speaker:through what you do, it doesn't exist. And part of the challenge,
Speaker:part of what I was always really concerned about is, yes, we can
Speaker:get people to diagnosis and we can get them there more easily
Speaker:and more accessibly than what is available in the market now. And we've done
Speaker:that, and I'm so proud of it. We're not done doing it. We're gonna keep
Speaker:changing how we do it, we're gonna keep modifying it, but we've by and large
Speaker:done that really, really successfully. But then what do you get on
Speaker:the other side? Like, there's nothing waiting for you on the other side.
Speaker:And it felt really bad to me to give people this,
Speaker:what might be a life affirming but is certainly a life changing
Speaker:diagnosis and have nothing for them on the other side. Because the
Speaker:only interventions we really have institutionally or in
Speaker:these programs anywhere are for children under the age of 13.
Speaker:And so what do you say? Like, people look at them and say, cool, you're
Speaker:an autistic adult, but you've got this far, so you can probably figure it out.
Speaker:And it's like, okay, they got this far miserable, or they got this
Speaker:far with a ton of really, really difficult situations
Speaker:that they had to figure out how to get through without any help, because nobody
Speaker:was talking to their brain the way it works. Because if you were able to
Speaker:get through it, it's probably fine. And so you reached out to me at
Speaker:the same time that I was probably publicly lamenting, like, I know we can
Speaker:do the diagnostic part. We have to figure out the aftercare part. And then it
Speaker:was like an instant, like, immediate, direct message of, like, I
Speaker:can help with the aftercare part. And I was like, okay, stranger
Speaker:on the Internet, I have no idea who you are or what you do, but
Speaker:tell me more. And now we have built the first of its kind
Speaker:program that will continue to grow in many educational and clinical
Speaker:ways. Because you were like, I can do this. And I was
Speaker:like, I'm gonna trust you. It's funny how many people I've been
Speaker:like, I think I can do this. And then they're like, okay, do it. And
Speaker:it's like, okay, let's see. Because I think
Speaker:to your point, like, what happens after this diagnosis? And
Speaker:there's this gigantic misconception that all forms
Speaker:of neurodivergent autism, adhd, anything else are just like
Speaker:mental health, and that there's differences in social interaction.
Speaker:It's like, well, no, there's all of these physical parts,
Speaker:whether it be the sensory experience that changes how
Speaker:I physically engage with the world, or my ability to motor plan
Speaker:and know how I actually put together the way I want my body to. To
Speaker:move to accomplish my idea. And then we layer on
Speaker:this level of intelligence that people often ignore, or they've
Speaker:been told that they're not smart because they can't engage in neurotypical
Speaker:education when they're actually, like, beyond intelligent.
Speaker:So, yes, now we have a diagnosis, but, like, I still am not making
Speaker:meaning of all of these experiences and being able to
Speaker:kind of be okay with my body and who I am and
Speaker:understand those strengths. And I think that's been kind of the, like,
Speaker:beautiful part about this educational offering, too. The
Speaker:sensory education program is every week just seeing people feeling more
Speaker:okay with sharing about how the things we're talking about connect
Speaker:with their experiences. It's in a way that unmasking,
Speaker:because, you know, they're protecting themselves. They're in this new group at first
Speaker:talking about things that we got some. Yes, it's resonating.
Speaker:But, like, now that we're, you know, we have just two sessions left,
Speaker:they're really sharing about their experiences and connecting with, like,
Speaker:oh, yes, that's similar for me, or a loved one or a child that I
Speaker:have, you know, those pieces. And Just that community around.
Speaker:It's not just me. It's also okay that this is happening. Or
Speaker:I now have an idea of how to navigate this tricky situation
Speaker:at work. Because I now understand why my body's
Speaker:having this response versus before, when it was a
Speaker:lot of that negative self talk that we're really great at as
Speaker:neurodivergence. Because there's just no understanding other than
Speaker:like, okay, maybe now with this diagnosis, but that points me
Speaker:in one direction. But there's all these, all these details.
Speaker:And then if you go looking for resources yourself, even if it's just, you know,
Speaker:searching TikTok or Googling, because there's not a lot of
Speaker:places to go for adults, how do you know that the information that you're
Speaker:getting is actual based on
Speaker:science and research and not an autistic person
Speaker:on the Internet saying things about their own experience? Like,
Speaker:anecdotal information is important and it's humanizing and
Speaker:it, it can be validating. And if we have the same anecdotal
Speaker:experience, that makes me feel understood, it makes me feel
Speaker:seen, it overcomes isolation, but that's still
Speaker:anecdotal. It's not something that you can apply
Speaker:to a body of research and say that there's any
Speaker:kind of commonality there. And so when people are forced to
Speaker:get there because there's not good information
Speaker:or not a ton of good information on the adult autistic experience,
Speaker:or let's say for people who are. We're talking specifically about the people
Speaker:who have been traversing the world to the best of
Speaker:their ability, trying to appear normal for their entire lives
Speaker:and then find out that they were normal only
Speaker:because normal doesn't exist. The way their brain works is for a
Speaker:reason, and we can teach them about that. But the, you know, for
Speaker:most people, the only information they're getting on that is from like TikTok or
Speaker:Instagram. And not to say that there isn't good information there, because there is
Speaker:a lot of good information, but there's no way to vet good information against
Speaker:bad information. We all end up with 15 different interpretations
Speaker:of the same thing. And a lot of people believe stuff that just isn't
Speaker:true. That's where they're getting their affirmation is from somebody who has
Speaker:anecdotal experience that is similar to theirs. And it doesn't mean it's not right. It
Speaker:just means it's not validated. Well, and then when someone
Speaker:comes in with different information or a different experience, then those
Speaker:individuals feel invalidated again
Speaker:because their source of Information was like a TikTok. And
Speaker:being able to use the evidence that we do have
Speaker:about sensory with neurodivergent populations and
Speaker:give them, like, really concrete information. Because part of what we talk about is,
Speaker:like, the neurology and physiology of some of these
Speaker:experiences. Because touch and tactile is a
Speaker:big piece for people. And, like, why clothing might feel uncomfortable
Speaker:and why that, you know, can cycle and feel different at different
Speaker:days is important to understand. But just understanding that you have different
Speaker:ways of receiving that information and processing it,
Speaker:because they're all being told, well, like, if you're okay with this, then why aren't
Speaker:you okay with that? Well, it's literally a different piece of the system. Like,
Speaker:it's not the same. So there's a part of this that I really want to
Speaker:demonstrate for anybody who's listening, because I think it's one thing to say
Speaker:we talk a whole lot about how brains work and how people
Speaker:process information. And that's true. And our education programs, like,
Speaker:I'm floored by them every time I look at something else that comes out of
Speaker:them. Because the things that we are teaching people that they have never understood
Speaker:before about how their brain works or how their senses work or how they process
Speaker:information. I always knew it was good information. I always knew that it was
Speaker:going to change the way, you know, it's going to rewire people's brains about how
Speaker:they think about themselves. But I got a message not that long ago from somebody
Speaker:who's been in our sensory education program the whole time. And actually I. It's
Speaker:somebody that I knew of, and I hadn't even realized that she had enrolled. So
Speaker:I. I just thought she was reaching out about something else. And she said, I've
Speaker:been in the sensory education program. I think it actually has changed my
Speaker:life. And I was like, hmm. But what she said
Speaker:is she has been to countless ophthalmologists
Speaker:during her life. She's, I want to say, like, in her 50s,
Speaker:so over 40 some years, she's been to ophthalmologists
Speaker:and basically said over and over, you're correcting my vision, but I still can't see.
Speaker:There's something wrong with my vision still. And they would test
Speaker:her and they would adjust her prescription and they would explain to her about
Speaker:eyes and what's happening and why. And she would say, okay, well, all of this
Speaker:is great, but I still can't see. Like, there's still
Speaker:something that feels like I can't see or I don't see well enough.
Speaker:Despite the Fact that you tell me that you have corrected my vision
Speaker:to the amount that it needs to be corrected to. And she actually
Speaker:worked in ophthalmology for a long time, so she's really acutely familiar with this
Speaker:field. And what she said in the message she sent me was, this is
Speaker:the first time that anybody has ever explained to me why my eyes
Speaker:don't work together and what is different about the
Speaker:way that I process visual information, which is the
Speaker:first time I've ever understood how to get my eyes to work together. This
Speaker:is all virtual. Nobody has laid a hand on her. We have not given her
Speaker:an eye exam. Not that we could. Not that we're qualified for that. She literally
Speaker:said, this has changed my life. No one has ever been able to explain this
Speaker:to me before. And now I actually understand how my brain and my body work.
Speaker:And it was just from, what, an hour of walking
Speaker:someone through the visual senses, that was the. The one that she responded to.
Speaker:When we say that we are creating something that is going out into the
Speaker:world and giving people access to information that they have
Speaker:never had before. In the small cohort that we've started
Speaker:with, we already have actual proof that it's changing people's
Speaker:lives. And that, like. Like, I literally have chills. Like, that just is beyond
Speaker:me. I can't believe that, first off, the information clearly
Speaker:exists. Like, it didn't get into your brain on accident. Why have
Speaker:we not worked harder to share this? Not we as in you and I, but,
Speaker:like, why is the medical infrastructure not taking this seriously enough to share it?
Speaker:But also, I mean, you and I. How many nights have you and I sat
Speaker:up until all hours going, how do we get this out into the world? What
Speaker:is the right way to do this anyway? So it's important to me that the
Speaker:world know that the work you are doing is really, really, really changing people's
Speaker:lives, and that we plan to do it on a larger scale as
Speaker:quickly as possible for a number of reasons. So the way we're doing it right
Speaker:now is an education program. We are not doing treatment. We are doing education. We
Speaker:are teaching smart people. All of our patients are smart. Everybody who
Speaker:walks into our practice is smart in their own way.
Speaker:And we do not assume that anybody is unable to
Speaker:access the information. And if they're unable to access it, we're doing something wrong. We
Speaker:need to change the way we're presenting it for this person. But assuming we
Speaker:made a wild assumption that if we taught people about
Speaker:all neurodivergent brains and all of the things we know about
Speaker:sensory processing, that they would be able to draw their own conclusions about
Speaker:how it applies to them. The reason that's important is that makes it an education
Speaker:program, not a clinical program. So we're not treating them for their
Speaker:symptoms. We're educating them about all presentations.
Speaker:And that's really important, because as much as we are absolutely also
Speaker:going to do a clinical program, and we're headed there probably faster than
Speaker:Jana realizes. Don't kill me. But the education program,
Speaker:because it's not gatekept by licensure, we
Speaker:can take it all over the world. It's not just limited to people who are
Speaker:in our country or our state or our time zone. We can take it
Speaker:everywhere because sensory processing is the same in the US
Speaker:as it is in the uk, as it is in Canada as it is. So
Speaker:the opportunities to build something that can
Speaker:impact autistic people or neurodivergent people or
Speaker:any number of presentations globally is,
Speaker:like, really real and really right in front of us.
Speaker:So to pivot a little bit, because I want people to understand the trajectory of
Speaker:how, not how we got here. I think how you got here, you
Speaker:weren't specifically looking for an affirming OT education. It
Speaker:just worked out to be. That was the education you got. So I want to
Speaker:understand the difference. Like, when we say
Speaker:affirming, what does that mean to you? What should that mean to the people who
Speaker:are listening? And then what does it look like on the other side?
Speaker:What. What is not included in those programs so they can kind of get an
Speaker:idea of the difference. I think the biggest thing with the
Speaker:affirming piece is that I am helping you understand
Speaker:you in a way that helps you use your
Speaker:strengths in a way that helps you make sense of
Speaker:all these experiences that
Speaker:maybe haven't made sense. And then we're
Speaker:able to collaborate by you telling me, like, what feels
Speaker:good to you, what are you interested in? What do you give a shit about?
Speaker:And then I'm gonna figure out how to help you
Speaker:reach that goal. The work is on me to understand
Speaker:you and what's important to you and where you wanna get. And
Speaker:then I have to do the work as the OT to figure out how to
Speaker:get you there. Because a lot of times what will happen is
Speaker:an OT comes in a room with a plan. And if you don't follow the
Speaker:plan, you are the problem. That's not
Speaker:affirming, and that's not what OT is rooted in.
Speaker:But that's what happens, unfortunately, because of all the. All the
Speaker:reasons that there's things wrong with healthcare across the world. But when we
Speaker:take on the work as the OT
Speaker:to make it so that this person can achieve what they're looking for
Speaker:in a way that understands who they are, what they're good at and
Speaker:builds those blocks up for them. That's affirming ot. So if
Speaker:I'm going to give you a really rudimentary example,
Speaker:one of the OT things that my dad did
Speaker:when he was recovering was to learn how
Speaker:to brush his teeth standing up. Again, he liked having clean teeth. It was like
Speaker:a thing for him. They had a way that they teach brushing your teeth standing
Speaker:up. But if you're somebody who doesn't care about brushing your teeth and
Speaker:you have no motivation for this life skill, what do you do
Speaker:in an affirming program to either get them toward
Speaker:that? Do you figure out alternatives like what's the solution there? I think
Speaker:I would go towards whatever it is that he's actually interested in.
Speaker:He can figure out brushing his teeth standing up if the
Speaker:goal is, you know, that he's able to stand and do things with his hands
Speaker:and not have to weight bear. I've gotten permission to make margaritas with a
Speaker:woman in a skilled nursing because that was what she wanted to do. Standing.
Speaker:Great, let's do that. And like we've made cookies
Speaker:because again, that was something that was meaningful for someone to then
Speaker:pass out to other people who lived in the facility or like with
Speaker:their grandkids. That's the start, right? That's the occupation piece.
Speaker:Because it's not about a job, but it's what's meaningful. Like that's
Speaker:literally what the heart of the profession was supposed to be. What do people
Speaker:find meaningful and how do we help them then recover
Speaker:because of that? And for me, I was in
Speaker:undergrad on my way to med school, even though I knew I didn't want to
Speaker:be a doctor because I wanted to spend time with people and get to know
Speaker:them and kind of help them on a recovery journey. A good friend of mine
Speaker:and a teammate was in a horrible car accident. It crushed her left side. She
Speaker:was left handed. She was in a coma and ended up at a brain injury
Speaker:rehab center. We got to go visit her because it wasn't far from
Speaker:college and I am not a hair and makeup person,
Speaker:but Tayda was very much always hair and
Speaker:makeup. The OT adapted all of her hair and makeup stuff so that
Speaker:she could do it for herself. And like at the time, you
Speaker:know, as a 20 year old, I didn't understand what they were
Speaker:Trying to do from a balance perspective, from getting that arm moving,
Speaker:the sequencing of it. I'm like,
Speaker:sorry, tearing up just thinking about it. Because here
Speaker:was my friend who for months, her whole life had just
Speaker:been like, in a bed in a hospital room. And someone knew that
Speaker:this was really important to her as a 21 year old, and they gave it
Speaker:back to her. That, to me, is just the beauty
Speaker:of what we should be doing in affirming ot.
Speaker:I did not know, I guess your hero origin story. I was gonna
Speaker:say your villain origin story, but I mean, poor Canola's dose. It could be both.
Speaker:You said finding things that matter to people to push them.
Speaker:And I just realized that this is a thing that we did. So when
Speaker:my dad was very, very sick and my daughter was six
Speaker:weeks early, my dad died when she was seven. Seven weeks old. So they
Speaker:only got time with each other because my uterus is
Speaker:trash. He had a great PT too. And his PT came
Speaker:over and would make him get up and walk with the walker and he hated
Speaker:it. And he would fight him every time. And my dad would do this really
Speaker:weird thing where he'd be like, no, I don't want to. And he'd be like,
Speaker:get up. And he'd be like, no, I don't want to. And he'd be like,
Speaker:get up. And he'd be like, okay, fine. And then the third time he would
Speaker:get up and it worked like every time it was just like a switch flipped
Speaker:and he was fine getting up. But toward the end, as he got more and
Speaker:more resistant to it, I would stand at the end of the hallway with the
Speaker:baby and just hold up the baby and go, come. And she was like two
Speaker:weeks old. He would get frustrated like, damn it, that works every time. And
Speaker:come traipsing down the hallway to go get his baby. But it worked every
Speaker:time. And that was what he was motivated by.
Speaker:He had waited a long time for that kid. And so I. I had not
Speaker:thought about that. I mean, she's about to be nine, so that long.
Speaker:There's something that you told me offline a couple weeks ago that has been like,
Speaker:running in my head nonstop. You explained that OT
Speaker:was not designed to be a physical health discipline. It was a
Speaker:behavioral health discipline when it started. Can you tell me a little bit more about
Speaker:that in ot? And sorry, I have an aversive reaction
Speaker:to the behavioral health. Just because the word behavioral health can. Have every aversive
Speaker:reaction you want. You are allowed. Just
Speaker:so if you saw my itwitch, you Know why it was that. That word. But
Speaker:we did. We started as a, like a mental health profession in World War II,
Speaker:where we were considered more rehab aged at the time. But working
Speaker:with soldiers returning from the war, finding things that they found
Speaker:meaningful because they were trying to physically recover.
Speaker:But they had all of these secondary mental health things that were going on, but,
Speaker:you know, they were kind of put in like an institution to recover.
Speaker:And weird, when you take away all meaningful engagement for people, how
Speaker:that doesn't help them physically or mentally get better.
Speaker:And in our education, we still
Speaker:have a lot of training in mental health. And how do
Speaker:you work with and support people if that's their
Speaker:specific thing? But even when we're talking about physical
Speaker:aspects, we're still talking about how are you addressing more
Speaker:than just the physical pieces? Because it is not kind
Speaker:of the separation of body and mind. It is one person. And those
Speaker:things directly influence each other. And
Speaker:I think it's Mary Riley, and I apologize if it's not, but
Speaker:she has this beautiful quote, and I'm probably going to butcher it, that it's
Speaker:man, through the use of his hands, empowers his own health.
Speaker:Something to that effect that is like the basis of
Speaker:ot, that by being engaged in doing, you're
Speaker:able to positively change your own mental and physical
Speaker:health. We probably should have started with this, but
Speaker:can you give me, like, a brief explanation of what
Speaker:OT is? Because I think a lot of people just assume
Speaker:it's pt. It's a very different discipline with very different
Speaker:goals. And I also think in the kind of physical health,
Speaker:or maybe more in the geriatric rehab world, they
Speaker:treat PT as the waist down and
Speaker:OT as the waist up. And that is. Now that I've worked with
Speaker:you for as long as I have, I know that that is not the case
Speaker:at all. And that is a giant kind of misunderstanding. Yes. And
Speaker:perpetuated again by insurance. Because then they try not to pay
Speaker:for, like, things like hip replacement for OT services.
Speaker:Physical therapy is really based in looking at motion. And how does motion
Speaker:promote health? Occupational therapy, though, that word, occupation,
Speaker:again, it's so confusing because it's not job. Right. It's an
Speaker:activity of meaning, something that gives people purpose
Speaker:and being that, you know, I'm primarily in pediatrics.
Speaker:I always have to explain that to parents. Like being able to
Speaker:get dressed. Right. Because that's meaningful for you, or to brush your
Speaker:teeth, because that is important to you. I've,
Speaker:you know, worked with individuals on hospice who all they want to do is be
Speaker:able to, like, Groom their beard, because that is important
Speaker:to them. And so giving meaning to that end of
Speaker:life. How else can we value humanity more
Speaker:than to make sure that even at the end, you're able
Speaker:to go out on your terms, you're able to die, you know, with
Speaker:dignity. We look at the whole lifespan that way. And
Speaker:with, like, all of this affirming work in the sensory space, that's why
Speaker:it's so important that it is comfortable when people are engaging in
Speaker:things, that they have said yes to, trying something new,
Speaker:and that they're put in a space in a situation that
Speaker:allows their brain to understand it, to make sense of it. I
Speaker:may consent to doing something like
Speaker:going to yoga in the morning, because then I know where my body is.
Speaker:But I may decide that I'm going to sleep in because I'm not giving
Speaker:consent to getting up out of bed at 5am so that I can do
Speaker:that before my tiny humans wake up. And we have to allow consent no
Speaker:matter how someone's communicating, no matter the age of that
Speaker:person. And I think that's the biggest thing,
Speaker:when people are looking for affirming OT
Speaker:that they have to make sure that they've been able to give consent.
Speaker:Because I know some of the people in our program, too, have children they're
Speaker:raising that are neurodivergent. And so they also have questions that come up
Speaker:with that. That's a big piece for me, for them, because we do see
Speaker:a lot of trauma coming out of people doing sensory therapy because it's
Speaker:being forced on them. And that's actually
Speaker:literally not what was ever supposed to be done. If you look
Speaker:at Ayer's, like, original work in this space, and her whole point is like,
Speaker:no, no, no, don't do that. That's not going to help. But it's
Speaker:just, again, people with productivity and all those things, I understand
Speaker:how they get to that space. And they weren't given the privilege that I was
Speaker:of truly being put on this, like, path to affirming sensory,
Speaker:because I happened to be the person who got the residency
Speaker:first. And it's just fascinating to me that, like, you're so
Speaker:passionate about it and you're so well versed in it that
Speaker:the fact that it was basically cosmic, not deliberate,
Speaker:just blows my mind.
Speaker:I know how you respond to questions like this. So I'm a little excited.
Speaker:If I could snap my fingers, have a fully funded,
Speaker:credentialed available to operate tomorrow
Speaker:program for affirming OT for every
Speaker:autistic adult in the country, what would. That look like, well,
Speaker:first I think it's education so that they can just basic,
Speaker:like, understand all the pieces, if we can start there,
Speaker:because then they can come to an ot.
Speaker:And having consented to say, like, okay, now that I understand my
Speaker:brain on this scale, I want to dive into some of these things that you
Speaker:talked about, and I want to be able to
Speaker:do this specific thing because, I mean, I will make one of these
Speaker:positive changes. So allowing people
Speaker:to come and say, okay, this is the thing that I'm looking at in my
Speaker:life right now that feels really hard. How can you help me? But now they've
Speaker:had kind of this knowledge base to be able to really come
Speaker:informed to those conversations so that the OT can help
Speaker:them really problem solve and navigate that particular thing.
Speaker:Than if they're like, okay, and now I'm gonna go try this, and then
Speaker:I'll come back to you when I have capacity. And, like, that's a part of
Speaker:our routine. Or I think that to me would just be beautiful because
Speaker:it is what people have capacity for. It's them
Speaker:understanding themselves. So even if it's not like, the specific thing
Speaker:that has come up, they're not having that negative
Speaker:voice in their head about all of the things or if
Speaker:it's coming up, at least they have another voice in their head that's like, but
Speaker:remember, you learn this, tell that voice to be quiet.
Speaker:So it sounds to me almost like the goal
Speaker:is to integrate OT enough into the
Speaker:programs we're building to. They turn to their occupational therapist in the same way that
Speaker:they do their psychotherapist. Different purposes, different goals.
Speaker:But when, you know, when you get into a relationship issue and you're not sure
Speaker:how to handle it, and you have therapy coming up, you're going to talk to
Speaker:your therapist about that. But when you get into a sensory issue, who
Speaker:do you talk to? If you have new neighbors who moved in upstairs
Speaker:and they're constantly banging and that's really bad for your sensory sensitivities,
Speaker:sure, your therapist can help with that, but they're not going to explain to
Speaker:you how your brain is processing that information and why
Speaker:it's getting you aggravated and how you can
Speaker:mitigate that. So if we could integrate OT
Speaker:in a way that treats sensory
Speaker:needs the same way that we treat, let's say, like, baseline mental health
Speaker:needs in. In a way that's collaborative. To your point,
Speaker:when you bring up, like, relationship issues, is that
Speaker:rooted in sensory pieces? The neurodivergent love
Speaker:locutions is like, how do neurodivergent folks
Speaker:experience, like, their engagement in
Speaker:relationships. And I just did this great training too,
Speaker:that talked about sex. Like, specifically, how does sex feel good or
Speaker:not good when you're a neurodivergent? And how does that all play into the sensory
Speaker:pieces? Like, there are people actually doing that specific
Speaker:work too, to help people navigate that piece.
Speaker:And so then as we're going through those things, how is it
Speaker:influencing our relationships? Whether it's an intimate partner,
Speaker:friendship. And so having that collaborative work with
Speaker:the psychotherapist and the ot, I think is like the
Speaker:best way to do it. I know we just talked about masking, too,
Speaker:in an internal awareness or interoception. And that was kind of my
Speaker:disclaimer. If you're going to work on this, you have to talk to your psychotherapist
Speaker:first because they need to understand that you're trying to work
Speaker:on better connecting with your body. Because that's going to bring up
Speaker:a lot of stuff. Because we try to not pay attention
Speaker:when we have internal signals about, like, safety and dysregulation.
Speaker:Because it's usually the things up here. I think when I think of
Speaker:historically, before I met you, honestly, I thought of a mental health care
Speaker:team as a psychiatrist,
Speaker:a psychologist, or a therapist, and
Speaker:like maybe the involved family. I always think
Speaker:a psychiatrist or a psychiatric clinicians should
Speaker:be involved, whether they're prescribing or not. I don't think that they should
Speaker:only be used for prescriptions. I think having them involved in a care team is
Speaker:important. The therapist who is handling the regular
Speaker:psychotherapy and an OT who can. And
Speaker:in the same way that our psychologists or our therapists and
Speaker:psychiatrists refer back and forth and share information back and forth
Speaker:and form a care team, the OT has to be involved in that. If we're
Speaker:talking about somebody who is really working through sensory struggles,
Speaker:or as you said, unmasking. I mean, there's so much complexity
Speaker:there the more we talk about it. And this has been where I've ended
Speaker:up every time we've talked about this. It's not an OT program,
Speaker:even though we call it that. It's not an OT program that is available
Speaker:with our mental health program. It's a program. It's one
Speaker:program. And our mental health program has OT
Speaker:involved. Jaina, thank you so much. This was wonderful. I just
Speaker:love listening to you talk about what you do, because nine times out of ten
Speaker:you say something that I have either never thought about before
Speaker:or never heard before. Because this is like the area of mental
Speaker:health that I am least familiar with, but you also come at
Speaker:it from a perspective that I. Not that I hadn't thought about it before, because
Speaker:that's the way we operate all of our programs, but just it has this
Speaker:incredible intersection of all of the people that we see. And it just
Speaker:blows my mind every time we get into it. So thank you so much for
Speaker:being here. Thank you for giving us the time. To everybody listening, thank you for
Speaker:stopping by. And we'll talk to you next week. Love you. Mean it.
