Addressing Neurodivergence and Insidious Trauma in Adolescents

By Derek Cragun, LCSW 

Neurodivergent (adj): “A word referring to folks that process and experience the world a little bit differently than the dominant culture.” 

We have many terms for neurodivergence, such as ADHD, Autism, learning differences, and so on. With different processing abilities, “neurodivergent” individuals can display incredible characteristic strengths, such as intense hyper-focus, passion, deep feeling/understanding, advocacy, attention to detail, and genuine presence. These are some of the reasons why I feel privileged to work with this type of individual.  

It is probably not any huge surprise that clinicians tend to gravitate towards treating the folks that they most understand. While I do not believe that there is a connection between sameness and good clinical care, I do believe that there is a connection between understanding and good clinical care. If we can truly understand the strengths, limitations, wounds, and environment of our clients, we can offer a higher quality level of care and develop a stronger therapeutic alliance with them. 

On its face, there is nothing inherently wrong with processing and experiencing the world in the way that neurodivergent folks often do. That said, there are legitimate, and sometimes serious, challenges that need to be addressed in order for neurodivergent folks to achieve their goals. To a certain degree, executive functioning challenges, difficulty with emotional recognition and processing, and social cue misinterpretation are workable challenges that can be addressed through a combination of therapy and life experience— though they will often present life-long challenges that require some degree of intentionality to navigate. 

Without dismissing the legitimacy or intensity for many of the aforementioned struggles, I would like to explore an area of neurodiversity that I see every day in my work that is commonly missed: Insidious Trauma.  

Simply put, Insidious Trauma occurs when the dominant society does not reflect the needs or unique aspects of the individual. Insidious Trauma is the constant exposure to, and experience of a person’s intersecting identities being in the margins of our dominant culture. Race, body size, gender socialization, physical ability, sexual orientation, and affection orientation are all examples of types of identities that are frequently marginalized in our culture. We are all complex people made up of complex intersecting identities, and the dominant culture values and represents some intersecting identities differently than others. 

Insidious trauma is the lack of fitting into the boxes. It is the chronic feeling that there is something wrong with you based on the things you see represented in your world around you. It is a cultural problem rather than an individual problem, but the internalization of that reality causes trauma and traumatic stress that is challenging to unpack.  

For the sake of this blog, we will focus on the Insidious Trauma of neurodivergent youth, with the understanding that all of their other intersecting identities are also present, and carry with them a certain degree of privilege and oppression. For every one of the neurodivergent youth I work with, they carry a unique set of identities that are more or less represented in our dominant culture: gay, straight, transgender, cisgender, White, Black, Hispanic, able bodied, disabled, etc.  

Every week, I meet with amazing, beautiful young people that have internalized intensely harmful ideas about themselves, the world, their place in the world, and their capacity. I sit with them in the wilderness as we reflect on and unpack these ideas. We grieve, we laugh, we give each other a hard time, and we muse about complex ideas. We process trauma, we talk about parenting, we face the scary things we don’t want to face, we play silly games, we make things with our hands, we struggle in the cold, we struggle in the heat, we relax, we revel at the beauty of the world, we celebrate our successes, we mourn our limitations, and ultimately, we heal.  

We respond to trauma by trying to regain a sense of power and control in our lives. With this in mind, it makes sense that the youth I work with frequently behave in ways that are not sustainable, acting to restrict their lives to small bubbles that they can control. They feel irritable, depressed, perfectionistic, rigid, self-destructive, defiant, and sometimes even suicidal. And since they are isolated, they usually connect with their peers through limited means, like social media and gaming. 

The neurodivergent youth that I work with are in need of healing. They have been redirected, corrected, misunderstood, judged, labeled, laughed at, misrepresented, not represented, and have been physically unsafe. Teachers, coaches, peers, parents, therapists, have all made well-meaning attempts to help them learn to “fake it.” These kids have often masked themselves to a degree that is not sustainable. Their behaviors are a direct communication of their needs, and they are in need of being genuinely seen, heard, and understood in a manner that will support them in embracing their strengths and achieving their goals.  

In a more perfect world, the dominant culture would adapt to the people that live within it. Until then, folks who live in the margins will need to continue adapting to the expectations of the dominant culture in a manner that feels safe and authentic to themselves. To truly be oneself in the world is a goal worth striving for. For many neurodivergent youth, this discovery of self-worth, confidence and empowerment can begin in the therapeutic process.  

It is no measure of health to be well adjusted to a profoundly sick society.” 

-Jiddu Krishnamurti    

About the Author 

Derek Cragun, LCSW is a Primary Therapist at outBACK Therapeutic Expeditions. Derek works with adolescents assigned male at birth who experience or have experienced anxiety, depression, learning and attention deficits, interpersonal/relational struggles, and more. To learn more about Derek, visit his bio on our website. 

outBACK Therapeutic Expeditions is an expedition-based Wilderness Therapy program for adolescents based in Lehi, UT. Our students come with a range of challenges that are addressed by licensed primary clinicians, associate field therapists, and professional wilderness staff in the Utah desert. For questions or admissions, visit our website or reach out to our team at 800-817-1899. 


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