The Whole Picture: How I Experience the World as a Neurodivergent Clinician

This is going to be a long one, but I think it’s worth saying.

As both a professional and a person with lived experience, I believe that sensory processing plays a major role in shaping how we develop, how we think, and how we behave. What many people see as “behavior” is often just a reaction to invisible sensory input, too much noise, too little clarity, too many demands on a system already stretched thin.

Sometimes what we call attention problems or emotional dysregulation is really just a downstream effect of upstream sensory challenges. For example, I often explain how auditory processing disorder can develop from early auditory deprivation. If a child can’t consistently hear speech clearly, because of background noise, ear infections, or subtle processing delays, the brain has to work harder to make sense of the world. Over time, that leads to fatigue, missed information, frustration, and what looks like “behavior.”

But it’s not just behavior. It’s a nervous system trying to cope with inconsistent input.

That belief shapes how I see people and how I work. And it’s also shaped how I understand myself.

For example, I’m autistic. I have ADHD, and I’m third-generation bipolar. I believe my mother was also autistic, even though she was never diagnosed. I have a son who is autistic, ADHD, and gifted. I’m gifted as well, according to testing, though I believe everyone is gifted in their own way. That combination of traits definitely affects how I think and process the world. I’m very sensory, especially when it comes to auditory and tactile input. I notice things most people don’t, and I get overwhelmed by things others might ignore. I’m more typical in some visual areas, but I struggle with depth perception and physical navigation.

I have close to perfect pitch, and I sing well. But reading music is hard for me. I also have trouble reading on paper because my eyes lose their place. It feels like the text moves, even though I know it doesn’t. I’ve tried Irlen lenses, and I often find myself reading with one eye closed. I do much better reading on my phone because the screen is narrow, the backlighting helps, and I can adjust the font size depending on how alert or fatigued I am. I also use Speechify, which lets me listen while I track with my eyes, and that combination really helps with comprehension and focus.

I don’t think in words like most people. My thoughts come in mind maps, mostly visual. That may be connected to growing up with sign language, which shaped how I organize and understand information. In particular, learning Cued Speech as a teenager completely changed my perception of how verbal language works. That exposure was pivotal. It gave me access to the structure of spoken language in a visual way, and it ultimately shifted the direction of my life toward speech pathology and audiology.

I have almost no sense of smell. My kids joke that I’m nose blind. I can remember the layout of buildings years after I’ve been in them, but I still get lost easily, even with GPS. I often don’t notice I’m hungry until I’m in pain. That’s related to interoception, which is how we sense signals from inside our bodies.

In terms of proprioception, I’m pretty clumsy. I don’t usually know where my body is in space. I do OK with signing, and that’s probably because I started learning it when I was about three. I usually know where my hands are, but when it comes to my feet, I tend to trip.

If I had to cross a rocky creek, I’d probably fall in. Escalators are scary because I can’t tell how fast they’re moving or how deep the steps are. As a kid, I used to hide in bathrooms at weddings because I couldn’t tolerate the background noise. It was either too loud or too layered for me to follow voices over the music.

When I’m fatigued, I do much worse. My auditory processing gets less reliable, and I miss a lot more information. Things I might understand or follow easily when I’m well rested just don’t register when I’m exhausted. I think that happens to most people to some degree, but I tend to mess up more in the areas that are already hard for me.

I’ve always felt a little reluctant to talk about the bipolar piece, even though it clearly influences how I experience the world. There’s still a lot of stigma around it. I know that autism and ADHD carry stigma too, but bipolar is often seen as something worse, something more unstable or threatening. That perception isn’t fair, but it exists, and it makes it harder to talk about.

Still, it’s part of my story. My mother had it, and so did my grandfather. He was actually jailed in Russia for sneaking in Jewish prayer books, not because he was religious, but because he believed people should have the right to choose. That kind of decision seems, in hindsight, like something influenced by bipolar, or maybe by a very strong oppositional instinct. I sometimes wonder if he might have been autistic with a PDA profile. It wouldn’t surprise me.

I’ve never been much of a follower either. That streak of questioning, of needing autonomy, runs deep in me. It’s part of what makes me neurodivergent. It shapes how I think, how I respond to authority, and how I advocate for myself and others.

I’m often anxious, especially in big social situations. I also struggle with executive function from the ADHD, and I have trouble maintaining attention during lectures or while reading. That’s one of the reasons I listen to audiobooks instead of trying to read print. All of the differences in how I process sensory input, along with my mood, affect how I see the world. That’s why I describe myself as neurodivergent. My perception is not average.

I can focus more deeply in my areas of interest than most people, and I tend to be highly creative. But at the same time, I might have a hard time getting through daily tasks in a routine way. I need formal structure with lots of breaks in order to manage a schedule well. That’s also one of the reasons I work virtually. I need the ability to take a break when my nervous system says I’m done. I used to sleep in my car or in a sound booth during lunch every day just to make it through the afternoon. It wasn’t always perceived well, but it was what I needed to reset.

When it comes to hearing, I’ve tried low gain hearing aids. I know how to program them well, and they did make sound a little clearer in some situations. But I have a hard time tolerating the physical feel of anything on or in my ears, especially for long periods. I also don’t struggle with listening enough for it to feel worthwhile in most environments. The only time I really notice a difference is in very noisy places, where my processing drops off more sharply. For now, it’s not something I use regularly, but I understand why others do.

I also think my energy patterns are a big part of why I’m neurodivergent. I don’t move through the day in a steady stream of effort. I work in bursts, moments of creative energy and hyperfocus, followed by periods where I need to rest or withdraw. This whole essay, for example, was written around 6:30 in the morning by whispering into my phone, then editing later. That’s how I work best. The ideas come all at once, then I go quiet.

That kind of rhythm doesn’t match well with traditional work environments. I’ve worked in corporate settings where I constantly felt like I was failing, not because of the work itself, but because the schedule didn’t fit the way my brain and body function. Doctor’s offices were a bit better. The patient flow created natural start and stop moments, which gave me time to reset between bursts of effort. At one practice, people would sometimes nap in the booth, not just me, because we were all so drained from the pressure. It was actually the first place I ever worked where I wasn’t judged for that habit.

I think in maps and strings. My mind clusters information by concept, kind of like in Beggars in Spain by Nancy Kress. Each concept holds its own mental space, like a little book in a library. I don’t have to remember every detail, I just follow the thread of the symbolism and structure. That’s how I process most ideas. They aren’t linear. They’re layered, associative, and bundled with meaning.

It’s interesting, when I look at my own case history from a clinical perspective, I can now recognize all sorts of traits that match known diagnostic profiles. My sound sensitivities and difficulty hearing in noise point toward auditory processing disorder. My eye tracking issues, the need to read with one eye closed, and my improvement with digital formatting suggest visual tracking challenges. My clumsiness and spatial disorientation point to proprioceptive differences. My emotional cycles, bursts of purpose, and crashes align with bipolar spectrum. And my late hunger cues reflect poor interoception.

But I think, as a clinician and a professional, I view myself, and the people around me, very differently than most. I don’t see myself as a list of disorders. I’m not a person patched together with Band Aids, each labeled with a diagnosis. And I don’t see my patients that way either.

I see whole people. People living inside complex sensory and cognitive systems that shape how they experience the world. People reacting to noise, light, movement, language, emotion, and pressure in deeply individual ways. I understand that what may look like inattention, avoidance, or emotional reactivity is often just a response to the internal environment, one that others can’t see.

That’s why I do this work. Because once you understand the sensory and mental landscape someone lives inside, you can begin to understand the choices they make, the patterns they fall into, and the behaviors that seem to puzzle or frustrate others. It’s not about labeling dysfunction, it’s about seeing the whole system, and finding ways to support it with clarity and compassion.

I also understand that when I reduce emotional overload, I gain more space to function at my best. And sometimes, my best may look neurotypical on the outside. I can perform, I can focus, I can communicate clearly. But that doesn’t mean the effort isn’t there. I have to be mindful of my weak spots. I have to manage energy, time, and sensory input carefully.

It’s like being a water balloon. Overfilled with pressure, it might hold together for a while, but it stretches more in some places and is more prone to burst in others. You don’t always see where the stress is building, but it’s there. Give it some slack. Give people some grace.

That’s what I want for myself and for others. Not to pass as something we’re not, but to be supported enough to operate at our best without constantly bursting under the weight of what no one else sees.

I think some people would say that I’m giving way too much information about myself, and that it makes me vulnerable to criticism. But this is how I process. It’s not that I overshare because I don’t know how to hold back. It’s that I can’t separate the parts without losing the meaning. I need to give everything in context, because that’s how I think. I think in connections, in whole systems, in threads that tie together history, sensation, mood, and meaning. That’s part of my neurodivergence too.

It’s a trial by fire, in a way. Being this open can be hard. It doesn’t make it easy to make new friends, especially in public spaces where people expect small talk and surface conversation. For example, my daughter and I went to Great Wolf Lodge this past weekend and met a couple of families we really liked. I probably gave them too much information. I don’t regret it, but I know those people may never reach out again. That’s the risk.

But I also have so many friends online, deep, meaningful connections with people I’ve never met in person, because I’ve opened my heart. I’ve been honest, and that kind of vulnerability tends to attract people who understand. Often, they’re neurodivergent too. And I think that’s partly because of something called the double empathy problem.

The double empathy problem suggests that communication breakdowns between autistic and non-autistic people don’t happen because autistic people lack empathy, but because both sides are speaking from fundamentally different experiences of the world. Neurodivergent people often understand each other deeply, even if they struggle to connect with the neurotypical world. So when I share this way, it’s not about needing validation. It’s about creating a space where people like me might feel less alone.

It also attracts people who understand why I will treat them as whole people. People who realize that I work this way not because I’m trying to be different, but because this is the only way I know how to be honest, effective, and fully present. The way I show up, with depth, with context, with my full self, is the same way I approach the people I support. I don’t try to fix parts. I try to understand the system. I see the nervous system, the story, the sensory load, and the need underneath the struggle.

That’s why many of the people I’ve worked with stay connected for years. It’s not just clinical care. It’s connection based on clarity, trust, and the kind of shared recognition that only comes when someone sees you as a whole person.

It’s also true that I may blur the boundaries a little between clinical and friendship, while still staying professional. But my idea of professionalism isn’t about hierarchy. It’s not about pretending I have all the answers and the people I work with know nothing. It’s about humility and shared learning. We all have something to teach each other. We’re all navigating complexity, and I believe in doing that with openness, respect, and care.

In all reality, this might read like it’s about me, about how I perceive the world. And in one way, it is. But that’s not really the point. I already know my story, because I live in this world, my world, every day.

What I really want is to hear about you.

What’s it like inside your mind? What do you notice that others miss? What overwhelms you, what grounds you, what lights you up? How does your body shape your thoughts, your senses shape your relationships, your energy shape your days?

Who are you?

You’ve heard how I move through the world. Now I want to understand how you do. If you’re willing, I’d be honored to learn from you.

I think it’s important that we’re willing to share our strengths and our vulnerabilities with each other. That kind of openness is not weakness, it’s the beginning of trust. I believe the next level of human evolution isn’t about technology or perfection, it’s about connection. It’s about moving beyond small talk into something real. Something reflective. Something that allows each of us to be seen, not just for what we do, but for how we experience the world.

When we share from that place, we stop competing and start collaborating. We start creating beauty together.

Visual Description:

A person made of a red water balloon, covered in bandages, each with labels of disabilities. Close to bursting with the water seeping out of the top, where the balloon opens. There is a crowd of people in a waterpark with colorful slides in the background. The water balloon person is standing in a crowd, but all alone.