When neurodivergent people in eating disorder recovery talk about exercise, the narrative that we are more susceptible to becoming addicted to it than neurotypical peers might be. "Be careful," we're warned, because adrenaline, endorphins, vestibular input, dopamine, and emotion regulation are all things that movement provides, and becoming dependent on it to self-medicate might mean overdoing it. If you're sensing a tone of cynicism here, you're onto me. To be fair, this exp

Pathological demand avoidance, also called pervasive drive for autonomy (though if you ask me-a PDAer-both names are lacking), is a hot topic in the neurodiversity-affirming mental health realm. I often see colleagues chastise each other in therapist spaces: "It's not oppositional defiant disorder, it's PDA. ODD isn't affirming." I get the same "ick" I used to get in treatment team meetings when my boss would interrupt staff who used the term "attention-seeking" by saying "Th

Have you ever had a small idea, a possibility, a "maybe" turn into something that felt emotionally real long before there was any evidence that it would actually happen? When it didn't work out, did the devastation feel wildly out of proportion to what actually occurred? If so, this may not be about being naive or idealistic. For some people, this pattern is shaped by how OCD relates to uncertainty, imagination, and emotional regulation. OCD is often misunderstood as a disord

The dog rescue worker brought out the puppy that ended up being my dog son, followed by his brother and rotated the two of them multiple times before I announced that I was stuck in indecision because I loved them both so much. When she reflected to me that it was clear to her based on my mannerisms and emotional expression that I liked one more than the other, I was truly astounded. How did this person know how I was feeling better than I did? Did it make sense to outsource

How low compassionate empathy can set the stage for moral OCD Most of us assume (and are taught) that caring about other people is a feeling, a warm, emotional pull that says, “Go comfort them. Go help. Go be there." We learn that good people are caring people, and to care means to be distressed enough by someone else's distress that you feel compelled to take action to alleviate it if you can. But that isn’t how everyone’s mind works, and if that's surprising to you, it's li

If you’ve spent any time in self-help spaces, parenting forums, or workplace “professionalism” conversations, you’ve probably heard some version of "Don't be entitled. The world doesn't owe you anything." Entitlement is framed as one of the ugliest personality traits one can possess. It's selfish, unreasonable, and corrosive to relationships, they say. And yes, entitlement can cause harm when it’s paired with exploitation or disregard for others’ needs. But fear of being seen

The idea that relationships should not be "transactional" is in line with the anti-capitalist values around which I live my life and practice therapy. It is true that healthy relationships are built on more than give-and-take exchanges of favors, but the key word is "more than." Those exchanges are still there, and they are still crucial. While it's romantic and Hallmark card-esque to believe that love and friendship should be unconditional and that care is best when it's giv

There is a tremendous amount of stigma around identifying as "gifted" as an adult. If you're thinking, "oh, poor gifted kids, must be so hard to be smart," I get it. It was that attitude, that kept this key piece of my self-understanding at arm's length for over 30 years. The fear of being perceived as conceited or—similar to how I felt in the early days of trying on my ADHD and autism identities—just plain wrong is a common reason adults who are "twice exceptional" don't eve

For those of us who are autistic and have an interest-driven nervous system, "special interests" (SpIns) are not just hobbies—they’re integral to our identity, offering comfort, focus, and a sense of mastery. An eating disorder may become a SpIn in and of itself or it may arise tangentially through other SpIns that either necessitate heightened awareness of one's body, eating, and movement habits, or are just muddied by the messaging of diet culture and involve a body ideal,

In college, I volunteered for a program to teach second-graders to guess what their peers were feeling based on flashcards of facial expressions, petting therapy dogs and imagining how they felt, and all kinds of reciprocal communication skill-building exercises. The program was called “Empathy Matters.” Those who had been signed up were the kids identified as having “behavioral issues,” bullying classmates, and seeming from the outside to not care about others. I wouldn’t be

Given that every individual has a sensory profile as unique as our fingerprints, and that every sense is involved in our experience of embodiment, it only makes sense that the way we approach healing our relationships with our bodies should be adapted to fit our very specific sensory needs. It’s exciting to hear more and more eating disorder providers remark that treatment can no longer be “one-size-fits-all.” But when individualizing a plan for healing, how are they taking