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Autistic Psychologists: A Portrait Spoken



Title: Autistic Psychologists: A Portrait Spoken

Release date: 1/3/2022

Co-created by: Giovanna Nicolau and Pablo de Assis

City/State: Curitiba/PR



[intro music]


Olga Aureliano:  I am Olga Aureliano and if you don't know yet, I am deaf and monocular, among thousands of other things, and I am with you on the Defiças [Disability] Portraits podcast. In episode 2 of this season, we presented the lived radio experience created by our compatriots Ticiane Simões and Lays Barros from Maceió/Alagoas, in an urban experience that explored a funny and  experimental encounter with visual impairment: we listened to the audios of the cane hitting the ground, the characters on the street, the train. Today is the day we publish the episode co-created by Giovanna and Pablo, who are autistic and psychologists, scholars of disability in the field of health. Enjoy.


[intro music]


[soundtrack in the background throughout the episode]


Pablo: Hi, my name is Pablo de Assis.


Giovanna: Hi, I'm Giovanna Nicolau.


Pablo: And we are here at the Defiças [Disabilities] Portraits Project to present you with a portrait. A portrait from our perspective. We will talk a little about the clinical practice of the autistic person, the psychological practice of autistic people, and how the autistic person is reduced only to a medical diagnosis, to treatment, and eventually ends up being ignored and invisibilized during this whole process. In other words, who is this person through the eyes of Psychology? Or better, who does he/she end up not being through the eyes of Psychology? To do this, I want to invite you, listener, to understand a little bit about how autism is understood by the psychological clinic, to understand a little bit of the science behind the understanding of autism and, finally, to understand what are the clinical demands of autistic people who seek psychological care.  And to be able to present you with this picture, I, Pablo, am a psychologist, a researcher, a university professor, and also autistic. I recently discovered that I am an autistic person, in fact, it is a story that I recently accepted that I was an autistic person, I already suspected it a long time ago and part of this process was discovered in my own clinical practice with other people. Even helping other autistic people, understand a bit of their reality.


Giovanna: I am Giovanna, I am a psychologist, researcher, professor, research coordinator, and I am also an autistic person. And I have identified myself as autistic some years ago, through my psychotherapy.




Giovanna: I'm already going to start commenting with you on how autistic people is seen through the psychological clinic, through my personal account, that at first you don't accept it, you don't identify it, you deny it, because you were taught to do that. You deny yourself, you accept as something strange or some behaviors, some hyperfoci, some instincts. Precisely because of this it is even more difficult for you to identify yourself as autistic, even more so through a process of psychotherapy, which usually what brings the medical diagnosis is neurologists, psychiatrists, in short, and therapy with age. So, I hadn't met anyone who had identified themselves as autistic, through psychotherapy or even similar to my process, until I met Pablo. In reality, I identified myself as autistic in my psychotherapy with him. So, I realized that it was a process we came to together and concomitantly, we could identify ourselves and also promote this process of self-acceptance.


Pablo: The great difficulty in this process, which was also a difficulty I had, is because we have a very technical definition of what autism is. When we try to speak about this, the word autism is usually associated with diagnosis. And in the clinic, generally, we think of a clinical, medical diagnosis of what autism is. And to make this diagnosis, we need to have some diagnostic criteria. And for this, we use the classic manuals, right? Mainly the DSM and the ICD. They even have criteria that try to be similar, but they are different. They are different visions. And this is what starts to cause a certain difficulty. To see autism as a diagnosis for psychological clinics is a very comfortable thing, isn't it? Psychological clinics sometimes like to have ready-made diagnoses and have a whole science behind them, which is used a lot in psychiatry, neurology and medical clinics, but the psychological clinic, first of all, is not unitary, right? You don't have just one type of clinic, you have several different clinics. Some will use this diagnosis, others not. The most common thing is to have a manual that says that according to the model, the biomedical view, autism is a general developmental disorder, which will generally be identified in childhood, which associates autism with cognitive delays or social relationships, indicating difficulties or delays in the field of socialization, language, which may or may not be associated with intellectual difficulties and may also be associated with sensory sensitivity…


Giovanna: Mh-hm [agreement noise]


Pablo: …When you make the diagnosis of autism, for children, you make an observational diagnosis. You observe, see the child interacting, see if they have these difficulties or not, compared to other children, so you can make the diagnosis. Some of these difficulties for some children are more evident, others not. And that's where the problems of the clinic begin. There is no test that can identify a specific marker for autism…


Giovanna: Mh-hm [agreement noise]


Pablo: … We barely have models that can explain how autism works. There are some studies that show different neurological developments for autistic children and children who are not autistic, but it is difficult to generalize if this appears in autistic people or not. These are just some correlations that we have found.


Giovanna: Mh-hm. Yes, as is the case with women. People of the female gender and people who identify themselves as women are taught from childhood to behave, to be quiet and stay still, to literally behave in a way that conforms to the social standard of identification, motivation, dress, etc. And they are often barred in the form in which they express themselves, and with this they become even more enclosed, closed, so that the person can express themselves the way they are, the way they would like to; in comparison to people of the male gender, who are considered to have an even greater possibility of expression, right? In quotes, this ‘freedom of expression’. This freedom, just the term freedom. The problem is because when we start to go a little deeper into this biomedical issue of autism, of associating autism to the color blue, right? That ‘blue angel’, that there are more boys than girls. There is still a relationship that they still say it is a disease, as if it were a possibility of cure, through this biomedicine to reduce autism. Actually, it is not even the name autism, right? It would be ASD, Autistic Spectrum Disorder, which is what it is called. So, this also relates to the issue you were speaking about at the start, I was thinking about this.


Pablo: When we talk about diagnosis and we do this clinic and we realize that the studies show precisely this data, that there are more diagnoses in boys than in girls, then we associate it with the color blue. It is exactly a way of not noticing the non-biological components of this experience of autism, right? I also don't like to say that it is an autistic spectrum disorder, because being autistic is not a disorder, although we can say that it is a spectrum, but [...].


Giovanna: Yes, I agree.


Pablo: [...] the relationship with gender is a very complicated one, precisely because there is a socialization of gender that is imposed on all children, even before they are born, right? Nowadays, even more with the baby gender-reveal parties, with the gender-reveal ‘tea’, even before the child is born a color is already imposed on the child. And that makes things a lot more complicated, right?


Giovanna: hum-hum.


Pablo: In my history, I was always a very shy child, very withdrawn. When I heard the story of autistic women who could never get the attention they were due, because they were never socialized as autistic, but always as women. Always as calm, always quiet, always creating social masks. I started to realize that my way of socialization was also like this, that's why it took me so long to recognize myself.


Giovanna: My experience was very different. I was a child who messed around a lot with other children, but I had an attitude like…, based on what they told me, in quotes, many quotes, ‘leadership’. They said that I had a lot of anger, that I expressed this a lot, and when I was alone, for example, I was very quiet and then they called me strange. Jeez, but with other people you are like that, when you are alone you are like that. Actually, they identified other diagnoses, but ASD was never considered. It was considered ADHD, dyslexia and other things, but none of them fit the manual.


Pablo: And it's interesting that this socialization is different for everybody. Since there isn't a basic pattern of socialization, we don’t even have a way in which we can generalize that autistic people are going to behave like this, this, or that. One thing we have to understand is that because of this variability in socialization, we have very different behaviors from different people. We learn how to behave, the behavior does not come in our DNA, it is not defined by the shape of our brain. It is due to different learning. I learned to socialize in a different way than Giovanna. What will end up defining autism, very much within this, is how our brains will manage to socialize, right? How we will be able to relate to society and interact with other people. Understand autism then, understanding social variations, it is necessarily then to give voice to the experience of being autistic, to allow us to understand how it is to have this experience, right? Legitimately, from the perspective of those who are autistic. Because otherwise, all the medical perspectives that will be reached will be based only on what the autistic person demonstrates.


Giovanna: hum-hum.


Pablo: And one thing that we always notice is that most autistic people learn to mask and to hide their own autism, precisely to hide these different ways of being. So, what we end up realizing is that being autistic implies a different perception, a different vision, a different relationship with the world. The autistic person himself/herself, many times will not understand social relations, the social cues. The autistic person will have difficulty in maintaining a typical rhythm of social interaction, like non-autistic people, because of this different functioning. And it is this social marker, these behaviors, that end up marking who is the autistic person. And that is why we will also think, from here on, that autism is a disability. Not only a diagnosis, a disability according to the biomedical model, that is, a lesion that causes a certain difficulty, but it is a characteristic that encounters social barriers. And here is the importance of us being able to understand that there is another model of understanding autism, which is not the biomedical model, but the social model. Disability studies, when they talk about the social model of disability, will say that "disability is the presence of accessibility barriers" and our society will present a lot of barriers for people who are autistic. For example, various barriers of communication. There are many autistic people who don't speak, who are not oralized, so these people will already encounter barriers to be able to communicate. There are barriers, and perhaps the main and most invisible ones are barriers in attitude, attitudinal barriers. These are behaviors that people have when dealing with other people. Many autistic people will present sensory hypersensitivity, very strong sounds will bother them, will cause pain, textures, smells, a very strong light will be very bothersome. And for many people who are not autistic, who don't have this hypersensitivity, provoking these stimuli in their environments is natural. Letting off a firework when you are happy, making a loud noise, using a lot of perfume, all of this is natural. This is a great nuisance for the autistic, and this ends up creating a barrier, because the autistic person can't approach, can't interact, can't socialize, and has these difficulties. But these barriers are linked to people's behavior, to people's attitudes. It's not a problem to be like this, the problem is to have to face a society that imposes barriers that, for us, are very difficult to overcome. When you have a barrier that is a disability that is more identifiable, for example, a stairway for a person who is a wheelchair user, we can see how difficult it is for a wheelchair user to climb a stairway alone, without help or without using a ramp or an elevator. But when we have a social difficulty, a socialization difficulty, it is hard for us to perceive that that person has difficulty starting a conversation, has difficulty changing the subject many times, has difficulty continuing a rhythm of conversation that, for that person, is not interesting. And then we think that they are making a fuzz, we may even think that it is a sickness, but we will not think that it is in fact a legitimate difficulty for that person, because of the way in which that conversation, that social interaction is built. That is why the use of the Social Model to identify autism ends up being important. This is why I like to use the word identification. Because it is not a diagnosis. It is not a label that the doctor will give me, it is the way I will see myself in these relationships. My great resistance to accepting myself as an autistic person was this. I saw how much the doctors I went to, nobody knew exactly what I was. Nobody knew how to understand me. They all wanted to say that it was anxiety, that it was depression, that it was anything, but it wasn't that. Until I got to know other autistic people, until I got to know them and I started to see that I function like them, I am like them. And a real identification happens, where I perceive their characteristics as being mine and vice versa. That's why I say that I identified myself as an autistic person, because of this socialization.




Pablo: The psychological clinic, is of course, based on science. And much of the science that is built to talk about autism is based on medicine, on biology. And it is undeniable that there are biological issues, as much as we recognize that autism is a psychosocial disability according to the Social Model, there are biological issues, there is a level of heredity related in the sense that families with autistic people have a greater chance of having other relatives who are also autistic. If the parents are autistic, the chances of the children being autistic also increases a lot. There is in this sense a certain genetic component. What is this component? We don't know. Even because we will understand that autism is a very large spectrum and very probably has several different neurological functions that are associated. There is a model that can be used, which is the model I like to use, which is to think of the autistic brain as a hypersensitive brain, in the sense that: normally our brain, which is an organ composed of several cells called neurons, receives stimuli from the environment, processes them, and sends messages to the muscles so that they can behave. All this, all this functioning depends on a certain level of excitation, that is, very weak stimuli are not perceived by the neurons. In fact, they are perceived, but they don't pass the message forward; there needs to be a certain intensity of stimulation in order to pass the message forward. And this is general, many times we perceive something and it gets lost or we don't have enough stimulation to generate a movement, and this is normal for it to work. It is necessary to have a great deal of stimulation to have a response from the brain. The model that gives to understand autism is that the neurons in the autistic brain are more sensitive, that is, they need a much lower stimulation in order to have a response. Consequently, we experience in our day, a perception to start with, colors are more intense, lights are stronger, smells are more intense. It would be comparable to a person who is not autistic hearing everything at a higher volume or seeing everything at a stronger intensity, or perceiving everything at a higher intensity. This all the time. It is as if we were watching a rock concert with very loud music, but all the time. This ends up being heavy for us. This overstimulation also leads to certain behaviors to try to compensate for this overstimulation, for example, some cognitive processes of information filtering. If we receive a lot of information, we don't know how to filter this information, we don't know what is valid and what is not, what makes sense and what does not. So one of these filtering mechanisms has to do with thematic choices. If we can turn all our attention to one theme, or few themes, we can filter all the information we receive. This cognitive filtering is what we call hyperfocus. It is not a characteristic of an autistic person only, in fact, any person can have a hyperfocus. But when it is related to the autistic brain, it is related to a way of filtering the excess of information that we receive. Then we focus on something else that facilitates the use of our brain, our attention, our cognition, to be able to interact with society. Another form of self-regulation due to this over-stimulation has to do with repetitive behaviors that we call stims, which come from stimulation or self-stimulation. These are behaviors such as moving the hands, rocking the body, moving some part of it, sometimes related to verbal stimulation. The person repeating the same sentence that we call echolalia, which is also a form of self-regulation based on this excess of stimulation. People who are very anxious, for example, can perceive this same type of behavior in their lives, but this is normal for an autistic person precisely because we are all the time with an excess of information, with an excess of stimulation. In one specific case, I remember that I filtered many of these behaviors, because I didn't see anyone else doing them, so I couldn't do them. I always, as I said, I have always been a very contained person, precisely not to show it, and I always disguised, always camouflaged these behaviors, until recently when I discovered that I allowed myself to do them. I began to see that I wiggle my feet or move in a different way, as is my autistic way of being. To be able to deal with it, to be able to work with it better. Also with regard to my hyperfoci, I have had several of them throughout my life. Some have lasted for decades, when they talk about science fiction, for example, I know that for me it is something that interests me, that I can concentrate, that I can talk, that I can participate. Many friends I have made this way. Some of them I suspect might be autistic, but they don't know it, do they? Because they are also very focused, very concentrated on this.


Giovanna: In my experience, when I was a child I had a hyperfocus on that band Rebels, on Wings, on Polly, on Barbie. But it was such a hyperfocus so large, so intense, that it was as if I wanted to be those people, as if I wanted to do everything related to those series, movies, characters. And people at that time thought "- Wow, how cute, right? She likes these things anyway, right? The girl likes these things. But I saw that it was much more than that, and I couldn’t even explain what I thought. Yes, I had a lot of hyperfocus, and I change my hyperfocus quite often even today. But when I get into hyperfocus, I get so immersed in this that, for my well-being, in a lot of quotes, to control this, so that I don’t do just this in my life, also, because it would be a problem for me, right? For my health and so on. I, with my hyper-focus, as far as I know this will be good for me, it will satisfy me, and I, of course, literally sometimes it is not even interesting anymore, sometimes it is a series that I liked so much that I finish the series in one day and it's over. And so, people think that this is a normal thing, not a hyperfocus, for example, because they say "Oh, but I am like that too, so if I am like that I am autistic too". And then we start to get into this issue of identification and this whole biological issue of "Oh, so everybody is autistic, right? Everybody is a little bit autistic. And even talking with Pablo... we were rethinking Simone de Beauvoir's phrase: "You are not born a woman, you become one", but we can identify, take a point there to talk about the autistic. It can be... "One is born ASD, but becomes autistic". It is exactly because of this identification that when we bring it to the field of disability, looking at autism as a disability is an identification, and because it is an identification, we look at all these social attributes that embraces autism, right? This autistic identity, this movement of Neurodiversity, movement of neurodivergence.


Pablo: The term Neurodiversity was coined in the early 2000s, by an Australian journalist, who is also autistic, named Judy Singer. When she goes to describe it, in conversations with other autistic people in the community, she begins to realize that the patterns of autism are a neurological pattern, and that we need to have an understanding that neurological differences are also acceptable. We have different bodies, different sizes, different genders, different sexualities, skin color, hair color, different foot size. But why do we assume that the brain needs to be the same for everybody? Brains are also different and this is natural. This is what Judy Singer was talking about, when she coined the term neurodiversity. And this is what we are going to refer to, when we talk about neurodiversity. Not as a biological characteristic of brains, but as a political position of accepting neurological differences as natural. So a person who has a brain that we can call schizophrenic, or a brain that we can call autistic, or a brain that we will give a medical label of attention deficit hyperactivity disorder, or schizotypal or whatever label we give, being a brain that developed this way and behaves this way, we will quote that it is a natural variation. In the same way that several different variations throughout history have already been pathologized, different sexualities have already been diseases, even differences in skin color or racial and ethnic issues have already been put as biological differences and diminishments, right? By eugenicist perspectives. We will also understand that dealing with neurological differences without taking into account this political position of accepting differences is also problematic. So this is what we want to talk about when we talk about neurodiversity.


Giovanna: We bring neurodiversity as this political movement and neurodivergence as this neurological difference. And drawing from this, I have a personal experience that, because I am a teacher, I teach about neurodiversity, right? Bringing it to this political field. And in this neurodiversity group, there are only neurodivergent people. In this study group we could put into practice all this part of identification, because many people came to the group without understanding what was happening in their lives, feeling lost, confused, because let's face it, it is very strange, it is different, it is stressful to identify yourself as autistic, after a lifetime of hearing that you were different, that you were strange, that you should not belong there. When you identify yourself as autistic and you start to notice other things and start to make sense of a lot of things, you start to realize that many of your experiences were also related to a level of violence, precisely from social systems, educational systems, institutions; They violated you throughout your life, implying that you had to build a thought, that you were taught, to look at yourself in a way "- Wow, I need treatment, I need medicine, I need to go to a psychiatrist, I need to go to a neurologist because there is something wrong with me, people are saying that I am strange, so I must really be strange and I don't know what is happening to me. So, in this neurodiversity group all the people that came in came in with this discourse of "- I have spent my whole life..."; and asking me: "- What do I do now? What am I now? Who am I now? Instead of defining yourself, right? What you are, besides being autistic, we can look at who you are at the moment, this transformation, this deconstruction of a whole life for a reconstruction, a new construction, from this perspective of neurodivergence. So, even from my experience in psychotherapy, I realized that when I first came to Pablo it was: "Oh, man, I am strange, people think I am super strange, I’m not able to relate properly, because they expect me to have a gender performance and I didn't even know what my gender was, I didn't even know if I identified myself as a woman, etc. We began to realize that the first step was to identify all this violence, and the second step was: "- ok, now what? Right? Giovanna in the middle of all this. I realized that it started to be deconstructed, when we identified that, when I identified myself in psychotherapy that I am autistic, things started to make more sense that I have hyperfocus, that I don't understand slang, many slangs I don't understand, I have to research their meaning; metaphors are very difficult, irony, sarcasm, I take it literally, because I don't understand, so I think that person is speaking literally and I say "Oh, great! Neurotypicals expect us to be able to understand what they are talking about, and even understand behind it and between the lines of what they are trying to say. But if they don't make it clear, at least for me, I won't understand what that person is trying to say. Because I will think a thousand things and sometimes it isn’t even one of those thousands of things, it is another thing that that person was trying to say and I didn’t understand. I also respect the neurodivergence that people force us to adapt to in their social environments. And in this group of neurodiversity, what are the violent reports of "gee, I had to adapt to my marriage", "- I had to adapt to college, because it was very violent and the professors assigned me with projects and papers every week and I had to do them even though I was having a breakdown, right? Super tired mentally and emotionally too. So it is very strange for other people to want to understand that social inclusion happens to all people, not just to one person, right? When we want to adapt only one person, it is not inclusion, it is still exclusion and segregation. So, bringing up a little more on this issue of how I have experienced it, even inside Psychology. I started my internship with autistic people, right? I started to do internships in clinics, in Curitiba. Autistic children, right? But the way these clinics worked was exactly in an extremely violent way, which we will talk later about ABA and TEACCH, other things like that. So, you adapt the person, you force him/her into a little box, like a jigsaw puzzle, you know? As if the autistic person were a puzzle piece to be fitted into some frame, something like that, but no, right? We can see that because we are a spectrum we can be a wave, we can be an infinity, we can be several things, except something to be fitted into something. Well, when I started to working in these clinics, they were the triggers for me to start noticing some other issues that I hadn't noticed in myself and that were very important for me to be able to work on them in psychotherapy. Then I realized that for me, I can stand very loud noises, music and so on, but if there are people chewing next to me, I can't stand the noise, I can't, for me it is absurd, it's like a sound so loud inside my head that I get so annoyed that I need to leave the environment, I get furious, I get very angry. And there have been situations throughout my life that I wanted to ask the person to stop eating with their mouths open and they said: "No, you have to accept that we eat this way”. So, there is no room for autistic people to ask for something that is bothering them, at least in my experience. Well, coming back, right? What I discovered, for example, in these internships. I also had the opportunity to do an internship in schools in Curitiba, with autistic people as well. They were autistic children and, bringing this issue of the biomedical and social model to the fore, in these internships I realized that people treated autistic people precisely because of this diagnosis and excluded them. So, if this autistic child was totally disorganized, she was not included, they looked at her strangely, excluded them, and she was left with this thought: "Oh, I don't have friends, I can't talk to people and I get very angry because I can't talk to other people, because they don't understand me. And the movement that I did in these internships was exactly the opposite of what they asked me to do, which was: "- leave the person alone, exclude them from the room, take them out of the room until they calm down, then you return with them. And I did exactly the opposite, I stayed close to her, I didn't exclude her and started to work on this inclusion with the children's class, right? With other colleagues and friends and even teachers, and it worked. That was when I started to research about neurodivergence and neurodiversity, but also linked to other themes, such as feminism, politics, non-violent communication, and education, which today are the themes I study and teach. And I began to realize that within these larger areas there is a lot of ableist content, a lot of content that excludes autistic and neurodivergent people, precisely because they are themes developed by white people, by heteronormative, neurotypical people, and there is no space or no part that bring in this issue of neurodiversity as a political movement, but also as inclusion of neurodivergent people, how this can be brought about from the protagonism of the neurodivergent person, autistic person, in short.


Pablo: This is a point you bring up that I think is essential for us to be able to think about the clinic, because when we talk about diagnosis, we always talk about an evaluation that compares a person to a diagnostic criterion, right? And we know what the criteria of the disorders are, or even the criteria of normality, which we can consider normal or not. But all these studies, all of them without exception are done on people without disabilities, starting with a large area of study called Psychology of Human Development. All the studies on the psychology of human development are conducted studying non-disabled people. Where we will see that a child with eight months will already start to look at the eyes, a child with one year will start to talk, will start to move this way and that, with two years will already have a linguistic formation x or y. But if we take just one autistic child and show that the autistic child will not look at the eyes or that he will have difficulties to start talking, right? Or if she will talk and she won't have as much verbal interaction as a non-autistic child, this identification made by these differences is very much by: "Look, the normal thing is to do this, and since you're not doing it, then you're different. And necessarily this is how the diagnosis is made. So, for example, we don't know what is considered the natural development of an autistic child, because all autistic children are already considered pathological, they are already born with a disease.


Giovanna: exactly.


Pablo: And when we try to fit people into this, even to identify autistic adults, it's another complication, because many times, as a child the person could have shown some of these differences, but it wouldn't be so glaring that it would demand some specific attention, right? I remember, for example, that I had to be taught that when I talked to other people, I had to look them in the eye. I remember that I was taught to do this when I was about 10 or 11 years old. And then, I just don't remember how I did it before, I really don’t remember. And I keep thinking today, "if I was taught to do this, I probably didn't look people in the eye before, right? To have to be taught to do this, but it was a characteristic that didn't call so much attention to the point of calling on people to think, "Look, people are looking you in the eyes, so maybe he is a sick person”. They simply said, "Oh ok, let's teach him, maybe he never learned", right? And in fact, I did learn, from then on I started to look people in the eye. At first I looked a lot, because, you know, if we are going to look, let’s not stop looking; and then I started to learn ways to look once in a while to. fake naturalness, which for me was never natural. But when we compare and use these comparison criteria that are diagnostic, they always become very complex, because every comparison in this sense leads to a standardization and an exclusion of diversity. This is a very delicate thing because we are talking about a diagnosis, about an identity, we are talking about people who are recognized as autistic, but if we take this characteristic of the clinic seriously, we will see that every clinic that is based on any kind of diagnosis is a clinic that tries to exclude, and this is a very complicated thing. Because we won't accept what the person is bringing as something natural, we will always read it through the eyes of the diagnosis.


Giovanna: Even in undergrad in Psychology itself, we are taught to do these conversion therapies. If the person is acting differently, you send him to a diagnostic evaluation, and precisely for this reason, you then have a multidisciplinary team of psychiatrists, neurologists. If she is acting differently, then she can't act differently, because then she can't be treated as socially inadequate, because in fact she is treated as inadequate, so you will have to fix her so that she adapts socially in the way that society ask. Obliges, right? Not asks. During my undergrad degree in Psychology, I was taught to segregate, to elitize, to exclude people, because even if we have a vision of Psychology that "- Wow, it is a science that aims at human subjectivity, that is going to include people, that is going to teach diversity and respect in regards to this", it’s the contrary, in fact Psychology is extremely violent, precisely because it is constructed and propagated by neurotypical, middle-class, white, cis people, etc. Right? People in positions of power. And these people do not accept people that diverge from this, that are out of this normative curve. Then I realized that I started to take other steps in the direction of realizing that new forms of public policies, of awareness, of other political movements related to neurodiversity were necessary. And, in fact, to bring this awareness to autistic people that they are not this medical diagnosis. Because I had experience as a clinician attending autistic patients and as a clinician attending at the school clinic of this university where I did my undergraduate studies. And I received some cases that were of neurodiverse people and you will see that they were neurodivergent people that were going through psychological, emotional, moral, within their families, educational violence and had no space for identification, no space to be able to express themselves. In fact, what they told me to do with these patients was to conduct a diagnostic evaluation to see what is going on with this person, what is wrong, why is he behaving this way? We begin to see that clinical psychology itself is violent and it also ceases to be a possibility, a potential tool for the inclusion of neurodivergent people. Of really accepting and respecting and listening to the perspectives of neurodivergent people, and allowing them to blossom this protagonism for their own lives. This is actually what Pablo did with me in my own psychotherapy.


Pablo: Yes, in this case, it was to allow Giovanna to flourish, right? To allow her to express herself. I think that this is the large potential that we have to begin discussing regarding the psychological clinic itself. Before we want to diagnose, classify, treat, cure, modify the person, we have to understand what makes the person who she is, what makes her unique, and autism is one of these characteristics that is part of who the person is. Before I want to transform, modify, and remove this autism from the person, I need to be sure that the person knows what this is, can understand him/herself in this relationship with him/herself, with the world, and with other people, be they autistic or not. And this is very complicated work that we don't learn in our training as psychologists, because in our training we learn exactly what are the theories and what are the techniques for fitting people in, for adjusting people. Even in those practices that claim to be more revolutionary, more open, there still exists this effort to fit people into box, there still exists diagnosis, there still is a reproduction of the biomedical model of diagnosis and intervention and prognosis. It may not be a therapy like ABA, which is Applied Behavior Analysis, which is actually a name that refers specifically to a treatment approach for autistic people, which was developed almost as a conversion therapy, literally, as a conversion therapy, a way for you to try to adapt. And in the beginning torture techniques were literally used, and at no time were autistic people invited to speak. Until today there are many people, many autistic people who speak against these techniques, who speak against these practices, and they are silenced all the time, because they say: "Oh no, because you don't understand the science behind it, because you don't understand the theory behind it"; or any argument of silencing, of using their titles, and position of authority in order to be able to silence the person who is a victim of these practices. And what hurts me the most is that these are practices used with children who have no way to defend themselves. They are practices used to reduce the anxiety of the parents because they see that their children are different and they don't want their children to be different. So the problem is much more of a breach of the expectation of paternity and maternity than in fact of a child that needs to be changed. And this is very sad. How does psychology, using science, using these practices enact violence on these children? It ends up being violent also with adults, when the adult goes to look for a job, but he can't be employed, because after all he is autistic and this position is not for autistic people, this position is not for a person with a disability, but he is totally capable of working in that place, in that way, but the fact that he already has a diagnosis, this is a reason for exclusion. And look how bizarre it is, because there is a law for quotas for people with disabilities that should serve as a tool for inclusion, but it is used as a tool for exclusion, limiting the possibilities of work. In my case, in order to get a job I have to present myself as a person who is not autistic, I do the interviews, I get in, so that afterwards I can say that I am autistic, because otherwise I won't be hired. And this is a reality. Where I teach, for example, I was instructed not to tell anyone that I am autistic, because otherwise, "How can that be? An autistic teacher? How can that be?” How to deal with the prejudices of students? So, okay, since you want to hide me, then I hide myself, no problem. So, this is the reality, we end up being invisible all the time exactly because we don't learn to deal with and accept diversity. For me, this is the great lesson that we learn by mentioning all this, by talking about it, you know, Giovanna? Dealing with psychology, dealing with people, dealing with psychotherapy is learning to deal with diversity, but the insecurity of dealing with what is different is something that we professionals need to learn to deal with. I became a much better professional when I started to accept that I was autistic, that I was different and that I was not supposed to be the same, that I didn't need to try to fit in because I would never fit in with other people's expectations. If I accept that I am different, I can accept the difference in other people, I can use my knowledge, my techniques, my practice and my power as a professional to create a space where other people can express themselves, where other people can be who they are and who knows, there in the office, start this little transformation. And she begins to accept herself in her relationship with me: "Oh, there is someone who accepts me the way I am. There is someone who understands my pains the way they are, who is not saying that this is wrong, who is not saying that I am sick. And little by little, this can be taken to other relationships, to other spaces outside the clinical office. I think that this is the path that we have to think about when we are going to talk about a more inclusive psychological practice. Not in the way we understand inclusion in a common-sense way, which is simply to deal with people with disabilities, but to have a practice that can literally attend to all people because we accept all diversities. Be it neurological diversity, physical diversity, gender diversity, sexuality, religious diversity, ethnic diversity, language diversity. We are working with people, and all people have the same biological basis, the same social basis, the same human basis, we live on the same planet. Because we have, precisely, this will to be who we are. Our work should be to find this space, to build this space, and our clinic should not be limited only to the office. I even think that this work we are doing here, making this podcast, is a clinical work of building this space, because I imagine that other autistic people or people who do not even know they are autistic will be listening to us and may identify themselves, and may recognize this work. Other professionals may also understand this. And we are helping to build this space of acceptance and inclusion, showing a little of our story, showing a little of our experience and showing a little of how our social reality is a reality that excludes which needs to be reviewed. Who needs to change is not the autistic person, who needs to change is society which excludes. Being autistic is not a problem, being autistic is not a disorder, being autistic is not a disease. Being autistic is being who you are, the problem lies in a society that excludes. And every time we say that the autistic person needs to adapt, needs to learn, needs to change because they are autistic, it is as violent as saying that a black person needs to change because they are black, or the woman needs to change because she is a woman, the homosexual person also needs to change because they are homosexual. It is just as violent. But we don't recognize this violence, because it seems to be normal. After all, autistic people are disabled and disabled people aren’t so much people. And it all starts with our clinical work in Psychology, because we reinforce this excluding view.


Giovanna: What I noticed in my clinical practice, being modified, and this was very evident, was when I finished my clinical internships in college and my patients said: "I think that you were the first person that offered me a space that was welcoming and listening to me, because you did not judge me and you showed me that the problem was not with me, the problem was with society, with other people that did not accept me the way I am". This reverberated so much in me, it was this clinical practice that I want to continue, that we should start to provide, that we should deconstruct all this elitist, colonialist, excluding psychology.


Pablo: Ableist.


Giovanna: Ableist. It is to start building this decolonized, inclusive psychology. I believe that this is what we would like to have passed on in this podcast.


[volume of the track increases].


Pablo: I think this is our portrait.


Giovanna: Yes, this is our portrait [laughs].

Pablo: It's a little bit about our life, a little bit about our practice in our area, a little bit about the difficulties we face. We have faced and are still facing them.


Giovanna: Exactly.


Pablo: Right? As professionals, psychologists, autistic people. Fighting against a system that excludes us. Trying not only to have a voice in this field, but also to give a voice to other people like us.




[intro music]


Olga Aureliano: : Ateliê Ambrosina is the NGO in Maceió-Alagoas that is leading the realization of Defiças [Disability] Portratis, a project funded by Western University in Canada. They work on the local production with me, Vanessa Malta, and Bruna Teixeira, and as researchers we have anthropologists Nádia Meinerz and Pamela Block. The script, recording, and editing is by Giovanna Nicolau and Pablo de Assis, co-creators of this episode; the finalization and intro music is by Rodrigo Policarpo, and the transcription is by Beatriz Simões, with proofreading by Bruna Teixeira and English translation by Deise Monica and Matthew Medeiros. See you next week.


[intro music]

Card cinza claro, quadrado, do podcast Retratos do Brasil com Deficiência. No centro de um triângulo em diferentes tons de lilás, a cabeça branca da medusa, de perfil esquerdo. O triângulo tem pontas arredondadas e está na horizontal, voltado para a direita. A medusa é uma figura feminina, da mitologia grega, com serpentes no lugar do cabelo. O rosto dela é branco e as serpentes são vazadas, com contorno branco, fino e parecem se mover em todas as direções. Na parte inferior, o nome do podcast. A frase Com deficiência está em negrito e Podcast, em negrito, maiúsculo.

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