In this episode, Amy talks with Charlie who is autistic and has a diagnosis of ADHD.
Charlie is a speech and language therapist and works on a stroke unit at a hospital. She talks about her diagnosis, her work and her passion for improvisation.
Host: Amy Ward
Guest: Charlie Gascoyne-Thompson
91eb023c0d805c6eb88376c3f674d231da851683
In this episode, Amy talks with Charlie who is autistic and has a diagnosis of ADHD.
Charlie is a speech and language therapist and works on a stroke unit at a hospital. She talks about her diagnosis, her work and her passion for improvisation.
Host: Amy Ward
Guest: Charlie Gascoyne-Thompson
91eb023c0d805c6eb88376c3f674d231da851683
I'm very much not a believer in this whole kind of like disability is a superpower
Charlie: I'm very much not a believer in this whole kind of like, disability is a superpower. It's not. It doesn't have to be. It doesn't have to be some awful, dreadful, tragic thing, but it also shouldn't have to be this thing that you sing about and you think is wonderful. I don't have to get up every morning and be like, I'm actually happier that I can't make eye contact and I lose my head if it wasn't screwed on. I don't have to be happy about that. But at the same time, I don't deserve to struggle for it.
Amy: This is works for me. A new podcast brought to you by Ultima Works, a specialist provider of connected services to enable neurodivergent and disabled individuals to thrive in their educational and professional lives. Each episode you'll meet with a neurodiverse or a disabled person to find out more about them, their journey, and how their disability and neurodiversity affects their professional and personal life. And I'm your host, Amy Ward. And today I'm delighted to be joined by Charlie Gascoyne-Thompson, who's a speech and language therapist. And, she's also here today to give us a bit of an interesting insight into what it's like to be working with neurodiversity and what some of the things are that she's encountered. Welcome, Charlie.
Charlie: Hi. Thanks for having me.
Amy: Could you tell us a bit about your neurodiversity?
Charlie: I'm autistic and I also have a diagnosis of ADHD as well. So Attention Deficit Hyperactivity Disorder for anyone not, familiar with the acronym.
Amy: When did you get your diagnosis?
Charlie: so I was quite a late diagnosis, really, an adult diagnosis. When I was in my 20s. It was just before I went back. I wanted to go back to university. And I think deep down I'd always had this sort of, deep seated suspicion that there was something about the way that I operate, particularly, in sort of high pressure, high stress situations where I wanted to know whether there was anything that was there that maybe then I could get support with and help with. but I initially was kind of seeking out an ADHD diagnosis. My younger sister was diagnosed as a child and I think looking back, there was probably quite a lot of similarities in us, in a way, but because that was kind of her, it was easy to sort of see everything that she did as being under that ADHD label. And anything I did that was different to her. Almost discounted. It's like, oh, well, I'd be much more like my sister if I had ADHD kind of thing. and then I sought out a diagnosis and got a bit of a two for one deal while I was there. So, the, psychiatrist, that was working with me picked up on a couple of threads, and just made some general observations and kind of followed that thread and led to me actually getting diagnosed as both with autism and ADHD. And there's a lot of crossover between the two. but, yeah, I think, gosh, I must have been 24. I would have said about 24. So about six years ago now.
Amy: How did you feel after getting those sort of diagnoses? Was it easier to begin to piece together your experiences now that you knew that there was a potential reason for this?
Charlie: Definitely. That is exactly what it was. It was a lot of unlearning. So I think if I think about things like, particularly with the ADHD, if I think about things at school, I knew I was lazy. That was always kind of deep down, it was always like, I do not apply myself. All the things like the teachers would say. I'd be like, yeah, I don't care. I am tired, I'm up all night, all these little things. But I think maybe there was this little grain of me that was like, I can't seem to stop, I can't change the way I am. And I think I've gone back and gone, oh my goodness, that makes so much sense as to why I spent half of my life picking my, folder up from the bus station because I'd left it on the bus for the 40th time. I always felt like everyone else was three lessons ahead of me in both life and school. It was that kind of thing. Everyone would be talking about the homework and I'd be like, what homework? I'd bring it, I'd lose it, I wouldn't have done it properly. I hadn't concentrated any lessons I didn't like. I was looking out the window. And I think when you've internalised that kind of, I am quite a lazy person and that is like a fault of mine, I found that I've really had to pick that apart for myself a bit, and really kind of acknowledge that while I do still display these characteristics of someone that struggles to attend to things that aren't motivating and can be disorganised, it's not through an inherent, like, I mean, even laziness of itself. People use that as, like, an insult. what is laziness, really? But I think certainly with me now getting that diagnosis, I'm like, it wasn't for want of trying. It doesn't excuse me, to be able to do whatever the hell I want, but it does allow me to kind of go back and observe that behaviour and be like, oh, there was a reason why this was so difficult. and I think the same with being autistic. It came as a bit of a surprise when I first got the diagnosis, because I was a bit like, oh, really? But then it was a lot of me kind of going back and sort of acknowledging so many of my social relationships the way I've approached situations. I've always been a people pleaser, and I think I look back now on that and be like, it was always more than that. It was always me masking in social situations, like work environments, to be like, I may not necessarily like this thing we're all talking about, but I'm going to say I do because it's just easier to be like, oh, yeah, I love that too. I hate that too. And then being exhausted from just this constant feeling of needing to kind of keep up with whoever's around me and kind of keep on their level. And it was very freeing from that perspective in that I could be like, listen, this is me, and this is how I present. If I can't integrate within a situation or an environment that may be more on them than it is on me. But it is a hell of a lot less exhausting to not just have to pretend to be a different person day in, day out.
Amy: Yeah. I was talking to a friend, of mine who also has autism, and she was saying to me that just knowing the general rules of engagement for every situation is a real minefield. knowing how to react, what to do, what to say.
Charlie: absolutely. It feels like, I think as a woman as well and as a girl, there are a lot of the kind of classic complexities of kind of teenage social situations. And I used to be like, I assume everyone has been given this information that I haven't. Like, I never knew how to hold myself. I look back on photos of myself in group photos, and I never know what to do with myself. I always felt bigger than everyone else that was there. like I was taking up space that people may feel that I was too close to them or too loud. and it led to a lot of mirroring behaviors. And I think it's probably where some of that kind of comedy kind of came from. It was a lot easier for me to be a bit of a class clown and kind of give into that, like, oh, I'm a bit weird, I'm a bit different, but that's okay because I'm playing that for laughs. So I didn't then have to try and be feminine, and interesting or whatever the social status would be that I was trying to sort of obtain. I could just be kind of the goofy one, and then I would get away with that. And it's really hard. There are a lot of, unspoken rules that even as adults, that you didn't realise you weren't meant to say that or you were supposed to have done something. And it's like, did everyone else get, a manual that, mine's still in the post. Where did that happen?
Amy: Yeah, no, for sure.
Charlie: You're exactly the same person as you were before and after the diagnosis, as it were. It's always been me, but it allows you to kind of put a name on it and really kind of explore all of what that means for you. Definitely.
Charlie is a speech and language therapist who also runs improv workshops
Amy: When I was looking into, some of your sort of backgrounds and things, I read a really beautiful little interview that you did. So I hope that you don't mind here, but I want you to cast your mind back to, I think it was 2019 or so. So, I don't know, is this first or second time at uni where you were at Sheffield?
Charlie: Second. So I did my undergraduate and my master's at Sheffield, but there was quite some space in between. So this particular interview that follows me to all areas keeps cracking. Not that I mind. I agreed to do it in the first place, but, yeah, it just seemed to. I think it's still on their website.
Amy: Yeah, for the Phoenix Remix, it was the interviewer, Rachel, I think it was, she actually said to you. So, as well as running little Chicago productions, you teach improv workshops. what are you doing to promote inclusivity? And your answer was particularly interesting to me because it led me into, well, this is perhaps where the love of language, speech therapy, obviously started to come in. So your answer, Charlie, was, as well as aiming for a better gender balance in our groups and shows, we aim to run our sessions in future courses, accessible to all of those with additional needs. I've recently developed a new workshop that aims to be inclusive to all those with communication needs and speech and language impairments. And then in brackets, my other passion. And so this was back in November 2019. So you hadn't actually trained to become a speech and language therapist at that point, is that right?
Charlie: No, I didn't graduate until 2020. I just started my degree. So, yeah, I was an improviser first and got into speech and language therapy from there. yes, I remember, the workshop I ran, and have run a few times now. It sort of combined those two areas of interest for me.
Amy: Let's go back and talk about speech and language therapy then. So you graduated from Sheffield with your masters. Was that in speech and language therapy?
Charlie: Yes. Ah, I got my Master's in Medical Science in Speech and Language Therapy in 2020. So it sort of comes with, a therapy qualification sort of within it, if that makes sense. So it's a two year Master's, unlike most Masters being a year. but that's what allows you to kind of practice under the college, under Healthcare Professionals Council.
Amy: Would you say that having your own neurodiversity and different way of thinking has actually added to being a speech and language therapist, the way that you perceive people's difficulties, the way that you perhaps tackle them?
Charlie: Absolutely. I think something I've said at work before, or sort of about work, is when you get a group (this also goes for when I've worked in schools before, I've worked with people with additional needs in sort of other areas. And it's exactly the same, but very much so in places like the NHS, because I work for the NHS and things like that) is when people talk about those they work with, with additional needs, they often talk in a way that assumes that no one else in the room this applies to. And while that doesn't always mean that they're saying something awful, it doesn't always kind of be sort of meaning to be a negative thing, but when you talk about a group of people in a way that others them, you're assuming A) That what you're saying is acceptable and that what you're saying is accurate and correct and empathetic and everything that we should be as healthcare professionals, you're also saying that, you don't believe that these people would be working with you. And I think it says a lot about the way that we see disability, those that say work with those with disabilities, that it's something to work for, but not work with. and I think I have often sat quite quietly in meetings where we've perhaps discussed a patient who's autistic, and people have made comments that while not even necessarily outrageous comments or anything that they've made, they would probably not have said it if they knew that the person sat next to them was autistic. Or they are operating under a huge misconception that the person's diagnosis, their learning difficulties, their additional needs are there for X, Y and Z. Oh, well, he's acting in this kind of way because of x, y and z. And I'm sat there like not only am I the speech therapist and I think that's wrong, I'm also the autistic speech therapist who thinks that's wrong and things like that. And it's particularly in schools as well, people are very happy to debate things like ADHD. They feel very comfortable having open discussions about things that they just assume doesn't apply to anyone in the room. So they'll be saying, oh well, everyone thinks their kid's got ADHD these days. What, just because he's running around and he's hyper and X, Y and Z and you're sat there as a person with ADHD hearing this, and not a single person in that room would necessarily know that about you. And it does change the way I think that people see neurodiversity in the workplace. People with neurodiversities, they're not just our clients, our patients, our students, they're us. They're your colleagues, they're your people you work with, work under. I think it's important that people who have neurodiversities in a workplace don't feel that pressure as well, that they have to be some kind of barometer of what's acceptable and not acceptable too. I should be allowed to be at my workplace and be autistic with a lowercase “a” sometimes. I don't always want to have to come in and be like, well, as the autism checker, let's run that past me or anything like that. I expect to work in a good, supportive environment. I shouldn't have to be the one kind of almost checking people for things. But it does give me an insight to be like, it's funny you should say such and such because in my experience I don't speak on behalf of all autistic people here, but as an autistic person myself, what you are saying is potentially a bit off the mark. So it's a bit of a double edged sword. It kind of gives me like a special little hat that I get to put on that gives me that extra little bit of backing with something I'm saying. But at the same time, you don't always want people to be kind of looking down the table at you and sort of checking in with you to make sure. Ideally, you would just be an empathetic person working in healthcare anyway. You shouldn't have to just check that you hadn't said something outrageous, or that you felt like you shouldn't say something because I'm sat there. You probably shouldn't say it anyway. If you wouldn't say it to me, you probably shouldn't be saying it about a patient.
Do you think improv does translate well into speech and language therapy?
Amy: So, thinking about working with patients then, do you think that improv does translate quite well into the role as a speech and language therapist? And I'm thinking about things like active listening techniques and thinking on your feet and, building rapport, because I think that's probably one of the cornerstones of a good therapeutic relationship, is that, rapport building. Has improv helped you with that?
Charlie: I would say so, definitely. I think if speech and linguist therapy is what I do, improv is what I am. So I think it kind of, sort of filters very much into kind of the way I present as kind of a speech therapist. I work on the stroke unit, so I work in sort of hyperacute and acute as well as rehab. And I think those improv skills allow me to be very flexible. So, for example, on any given day I can be seeing someone within hours and minutes of their stroke. And I'm doing like swallowing input. I'm doing a lot of assessment, I'm being very analytical, but I'm also dealing with a patient and their, family who've just received this diagnosis. They may be quite medically unwell. And I'm playing that character, as it were. I'm putting on that face. And then five minutes later I'm seeing the patient who's been with us for six months for communication therapy. And I know them and I'm pushing them and I've got that kind of rapport with them. And, I'm the same person, just with different hats. It's the hat thing again. I'm bringing hats up. All that's very hat themed pod. yeah, I've got that kind of. And I think improv is great for that because it's almost like in an improv scene, even just like at its core, in any kind of improv scene, you're being given a gift, you're being given an offer and you're running with it. And that's what working on the stroke unit is like. sometimes those gifts may be people choking on mini cheddars, sometimes those gifts are just patients telling me where to go. And other times it's patients making progress, whatever it is. Whether it's firefighting or it's just kind of generally tackling the problems or the to do list in front of you, that kind of flexible, plate spinning approach that you get from improv absolutely works so well, I think, in speech therapy. And it also allows me as well, to kind of remain that kind of professional, empathetic sort of. They talk about this a lot in healthcare, that it's not about sympathy, it's about empathy. And I think that's very hard for a lot of people to understand because most people, particularly people that go into healthcare, they're very good people with lots of feelings, and you come across dreadful things all the time in our job, that if you genuinely took everything on all of the time, you wouldn't get past Monday. And I think with improv, like being able to have that almost kind of - I'm using some kind of slightly naff phrase in here - but like, that slightly Brechtian kind of. I've run on, I've put on a hat, I've done a thing, and then I've left and it's gone. And I've drawn a line under it. There's a bit of an element of that where it's like, I am the person that they need in that moment, but when I go and I move away, I don't take that with me. I don't do them kind of the disservice of burdening myself with the situation in order to not be a good therapist in three minutes time. And I think improv, there's a lot to be said for that kind of ability to pick it up and put it down. it's everything in that moment and then it's gone. So, yeah, definitely.
Amy: Yeah. So do you think improv can actually be really helpful for people with communication difficulties?
Charlie: We run a communication group, on the ward that I have, and I think a lot of what you're always trying to kind of look at promoting within speech therapy is functional recovery. So it's very easy to be like, oh, you're having some difficulties getting your words out. Let us sit for an hour a day, and we'll practice naming 60 pictures of different animals until you can get less than five errors. And you go, yeah, that's absolutely fine, but what is that for a person? What does that represent in a person's life? Being able to name 60 animals slightly quicker than they named 60 animals yesterday. And so the communication group is, by all intents purposes, a conversation group. And a lot of that is improvised to a certain extent, you're looking at trying to facilitate an environment in which people can have spontaneous conversation. They can actually say what they want to say. They're hearing what another person is saying and picking up on it. And it's very much kind of what my. I do a workshop about communication that is based on kind of the principles of communication. So, quantity, quality, relevance, and manner. And when you're looking at facilitating a good communication environment for those with communication difficulties to improve within, you want to always be thinking about those things. So, for example, if you've had a patient who's had, a frontal stroke, that can sometimes affect their inhibitions. They talk a lot, they often are very verbose and will fill a lot of that space. And what you want to kind of allow them to be conscious of is the extent to which they may be dominating a conversation without meaning to. And similarly, for someone with, an aphasic presentation who can't get their words out, you want to be recognising how we can look at supporting them to get the most out of it. We all know that say, within an improv scene, how much can be said by not saying anything, just with a look, a smile, a nod, a single word can have a lot of gravitas than the person on stage. That's just jabbering, jabbering, jabbering and steamrolling the situation. And it can be about tilting that balance and looking at that. And so I think there are a lot of those kind of communication principles that are really applied through improv and then vice versa. kind of for our patients, how we can kind of get them thinking about listening to the other person, taking that gift, taking that back on, and how they can then sort of develop their own communication skills in their recovery.
Attitudes towards additional support needs to change across the board for disability
Amy: With that, what would you say are, some of the biggest points of concern that you have found now when you cast your mind back since your diagnosis, when we think about education, when we think about neurodivergent support in the workplace, are there any things that you think actually could be improved from your own experiences?
Charlie: I think the attitude towards additional support needs to change, and it needs to change across the board for disability. The two things that really stand out to me, both from my own experiences, kind of pre diagnosis, and then from my experiences of kind of studying disabilities, I guess, as part of my degree, and sort of seeing it from kind of both sides of that, is everyone wants the same thing. Everyone wants there to not be problems for anybody. But no one can really fully seem to recognise what that looks like, and I think if you take kind of like, the social model of disability, there's a lot to be said for actually, it's society that is disabling and restrictive, and I absolutely agree with that. However, I do also think it's important not to shy away from the fact that a lot of disabilities cause things to be more difficult for people. I'm very much not a believer in this whole kind of, like, disability is a superpower. It doesn't have to be. It doesn't have to be some awful, dreadful, tragic thing, but it also shouldn't have to be this thing that you sing about and you think is wonderful. I don't have to get up every morning and be like, I'm actually happier that I can't make eye contact and I lose my head if it wasn't screwed on, I don't have to be happy about that. But at the same time, I don't deserve to struggle for it. And I think a lot of that comes with us really recognising what we mean by additional support. It's not about making things easier for people, but it's also about thinking that something that looks like a get out of jail free card for somebody, something that looks like pandering for someone, it's so easy to see people actually just being given kind of the equity that they deserve as some kind of pandering. No one calls wheelchair ramps pandering. people would recognise instinctively, oh, well, of course, if there are people in wheelchairs that would need a ramp, then they would need a ramp. But suddenly, when people start suggesting steps within sort of disability adjustments that maybe are somewhat inconvenient for others, even if they're arguably quite simple things, like, for example, the big ridiculous debate when it was like, oh, they're banning clapping at graduations. No, they're not. But even if they were, who loves clapping that much that they wouldn't be prepared to just not clap? And it's things like that, suddenly it's this idea that any real step into making life easier for people that possibly encroaches on a non disabled, on a neurotypical person's experience of life, is suddenly like, oh, my goodness, that's too far. And this happens so much in schools, like, oh, well, that kid gets this, but my kid doesn't. Well, does your kid need this? And it's obvious on the surface, but it's very much ingrained within the way that we are as a society. We have people that go into healthcare professions who really want to help those who suffer. Help those who are poorly want to fix people, but God forbid you ask them to put subtitles on a training video and suddenly it's like, oh, my God, what the hell? Really? And you're like, right, well, I guess you didn't love people with additional needs quite as much as you said you did in your interview. And I think that is probably the biggest thing for me, is, like, speak to disabled people. Get disabled people in and working in your environments, rather than trying to work out what they might need, ask them. And instead of asking them, pay them. Actually employ them. Don't just come and get a little bit of free labor off that guy that, you know, that's autistic, and he might tell you how you think more autistic friendly and go, cheers, mate. And then leg it. Start employing people. Start having people within your workplaces who are disabled, who are neurodiverse, and you will suddenly find that you become a much more accessible workplace because you have the people making the decisions, seeing things from this point of view, and I think very much as well. It's absolutely okay to talk about disability and talk about neurodiversities as things that are harder. It's okay to recognise some of the more negative aspects of disability and neurodiversity, but without always putting that onus back on that person. If there are things that can be done to alleviate some of those issues, that's fine, but don't put it back onto that community to be like, well, hold your heads up high. It's not disability. It's disability. Those kind of things. I find, extraordinarily patronising and very much paper over the cracks of the real issue at hand, which is, no, these things are harder for us. And actually, rather than just pretending that autism is my superpower, let's actually look at how you can support me as an autistic person to function within this thing.
Advice for somebody struggling with or looking for a diagnosis of autism and / or ADHD
Amy: What advice would you actually give somebody with autism and or adhd? So put both hats on now, Charlie, what advice would you actually give them if they are struggling with, a diagnosis or they are actually perhaps looking at seeking a diagnosis?
Charlie: I think the two biggest things. The first thing would be find your community. It doesn't have to be a community of other people with ADHD or autism or whatever it is, but find the people who you trust implicitly that will listen to you, that will adhere to anything that you sort of request in terms of, like, if you need x, y and z, or can you please not do x, y and z? Find those safe people. and I think I would also really just encourage people to think about what their neurodiversity means for them. So don't try and make a diagnosis feel like a diagnosis has to kind of match you or you have to match up to, oh, well, I hit nine out of ten of those things. Do I have number ten? Don't worry about what it says on paper. Believe me, if you are autistic, you are going to resonate with the diagnostic criteria. Like, ultimately, that is how a diagnosis is given. And whether that is a self diagnosis or sort of like a professional kind of medical diagnosis, they are literally just going to be looking at ways in which you match those criteria. It's not about sort of, well, I don't do this thing, or I'm not as ADHD as my sister in my particular. And actually it's not about thinking about things in terms of like, do I tick all of these boxes? Am I autistic enough? I would think about the ways in which you are starting to recognize how the way that you are, the person that you are, the way that you sort of present, and the things that are easy for you, harder for you, how they are influenced by your neurodiversity. I think one of the biggest things that's starting to kind of turn a little bit particularly kind of within autism is we talk a lot about it being kind of a spectrum disorder, but actually, like many disorders, it's more of a dimensional disorder. And by which I mean it's not about kind of high functioning this, low functioning that, or severe or mild. You're not mildly autistic. No one is mildly ADHD. At the same way. You don't have severe ADHd either. You have areas of functioning within your ADHD that you may find considerably more significantly impacting on you than others. I know for me, with something like with autism, there are areas that I have absolutely no real issue in, and there are areas that I find impact me greatly. And within that, I still am autistic. Those are still autistic things about me. But I don't look like my friend who presents slightly differently. And I think, as in life, none of us are all the same. And so don't be afraid to consider that something about you that you find difficult or something about you that you find different. It could absolutely be a part of that neurodiversity, that label that either you've taken on or that you're seeking, but it also doesn't have to be. And, it absolutely is about identifying for yourself. Like, what do you recognise as being part of your story? What do you recognise as being part of your neurodiversity? Rather than feeling like you have to match up to someone else's, really from an official diagnosis point of view, the only person that's going to take that evidence is the person whose job it is, is to assess you. If that evidence matches within that criteria, that's a diagnosis. It doesn't. Doesn't. There's no concrete, answer that's sort of given. I know that when I got my ADHD diagnosis, I felt like I was reading the Charlie assessment. It was bizarre. Like, the amount of very seemingly specific questions and tangents it went on. I was like, I can't believe you're asking me this. I mean, it's true, but that's really random. What are you talking about? And it's because actually what we think we know about neurodiversity is like, a drop in the ocean of to how things actually are. And with something like autism, it's not just those couple of things that people think. It's so pervasive in so many different areas of your life that, yeah, don't be afraid to recognise that anything about you that you feel is part of that neurodiverse identity is absolutely valid. And find out what that kind of means for you.
Amy: What are you most proud of in your life now so far, both as a person, as a, speech and language therapist, but also as somebody that identifies as being autistic and you've got ADHD.
Charlie: It's more the fact that I have managed to achieve anything that I set out to achieve. Where I was pre diagnosis, I'd written off so many things for myself, like academic achievement, holding down, a difficult job, a complex job, a job where I'm in charge of things, and people have to ask me my opinions and things like that. So I'd say that, simply passing the degree and achieving the job and continuing to kind of thrive in it is something I'm proud of. But I think what I'm proudest of is that I really like my job. I'm proud to have found a career that I genuinely love going into work and I really always want to do my best in, and, feel that I can thrive within that since my diagnosis and been able to kind of recognise where I need that support all along. Perhaps it turns out that I could be a high achiever, I could do things I wanted to, things that were difficult. And so for me, I think it's that really, it's being able to do what I do every day and love it. I'm very lucky, and I also recognise that there are a lot of things within my life that I'm very lucky to have a good support network. I'm very lucky in that the opportunities I have had. And not everyone starts off on even keel with things like this. So there are a lot of things that will make achieving those things much harder. But support is always out there, and I think whatever you want to do, you can do it, providing that you are adequately supported. And I think there's a lot of shifts within society that we have to do. There's a lot of groundwork that needs to be done, a lot of changes that need to be made, but no one should ever feel that they can't do something and can't achieve something simply because of a label or a perceived difficulty, a barrier, to that success.
Amy: If you want to find out more about some of the things that we've been talking about today, then there are some handy links in the show notes and we'll see you on the next episode.