From Stigma To Support: Dr. Mercedes Okosi On Trauma, Culture, And Neurodivergence

What if “it’s just anxiety” isn’t the full story? We sit down with Dr. Mercedes Okosi, a New York clinical psychologist, to unpack why autism is so often missed, how anxiety can mask deeper needs, and what truly supportive care looks like when culture, cost, and stigma are all in the mix. This is a practical, human conversation about getting past labels to build lives that actually work.

Dr. Okosi traces her path from early curiosity to a decade treating trauma, PTSD, depression, and anxiety. She explains how 2020 forced many people to confront what distraction once hid, and why non-specialist training and overlapping symptoms contribute to late autism diagnoses. We dive into the difference between everyday traits and clinical thresholds—focusing on impairment, compensation, and the real toll of masking. Along the way, we question media stereotypes that flatten neurodivergent lives into extremes or cute edits, and we talk about that “trapped emotions” feeling that rarely gets airtime.

Culture and access run through everything. Working with immigrant families and first-generation adults, Dr. Okosi shows how cultural humility—starting with shared goals like better regulation or fewer blowups—builds trust and results long before a label lands. When medication comes up, she frames it as one tool among many, paired with clear timelines and ethical psychiatric consults. We also get tactical about social scripts, friendship, and parties: when to skill up, when to unmask, and how boundaries and assertive communication turn difference into direction.

We close with self-diagnosis and next steps. Testing is expensive, waitlists are long, and curiosity is valid. Dr. Okosi suggests clarifying what a diagnosis will do for you—community, language, accommodations, treatment options—and seeking evaluation when possible to rule out lookalikes like auditory processing or learning issues. You are yourself before and after any label; accurate understanding is what unlocks growth. If you’re navigating autism, anxiety, trauma, or cultural stigma, this conversation offers language, tools, and a kinder path forward.

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Transcript

Welcome And Season Vision

SPEAKER_07 0:00

Hey everyone, welcome to the NeuroFucks Podcast. I'm your host, Jackson Rosa. Over here we have the wonderful, lovely.

SPEAKER_03 0:06

Oh, Hayley Olivia.

SPEAKER_07 0:08

Don't act surprised.

SPEAKER_03 0:11

Okay, wow. Oh, you're being really nice to me right now. I don't know what to do.

SPEAKER_07 0:16

It's all you think I'm a schemer? You think I'm just saying nice things?

SPEAKER_03 0:22

No, no, but anyways, welcome to our podcast. If you're new here, join us. Come in. Enjoy the vibes, enjoy the information. We have a whole bunch of awesome guests coming on this season. Right, Jackson?

SPEAKER_07 0:38

We do, and it's incredible. We got artists from all walks of life. We got wonderful people in entertainment and acting and the arts and uh music and psychiatrist and animation and a psychiatrist. And you know what's great about that? We are fulfilling the mission of this podcast, one subscriber at a time. So, you know, you should subscribe. Maybe uh send us a little donation too.

SPEAKER_03 1:03

Yeah, and if you are not new here, welcome back. We wrapped you in our clutches and you're never leaving.

SPEAKER_07 1:11

This is her manipulative slide coming out, son. Oh sh.

SPEAKER_00 1:17

It's time for NeuroFox Podcast with your host, Jackson Roaster, that mischeviest mother. Haley Olivia, what's your name, girl? You on the spectrum and terrence. We've got autism, ADHD, O C D, all the deeds. We got stories and artists from all walks of life. It's time to give neurologically.

Meet Dr. Mercedes Okosi

SPEAKER_03 1:46

All right, everybody. So this is Dr. Mercedes Ocosy. Um, and she is a clinical psychologist from New York. So, um, Dr. Mercedes, would you like to give a little bit of your background and a little bit about yourself?

SPEAKER_02 2:06

Yeah, thanks for having me, first of all. I'm honored to be the first uh psychologist guest. Yay! Uh so as you said, I'm a clinical psychologist. I work in New York, in a university, and also in private practice. I have been practicing now for or licensed now for the past seven years, but I did a Psy D, uh, which is a doctoral program that more heavily emphasizes clinical practice. So I've been seeing patients and treating people for uh over 10 years now. Um I specialize in trauma and PTSD. So a lot of people seek uh me out specifically for that, but I see a range of people from people dealing with everyday stressors and life transitions to testing um to more severe and persistent mental health presentations. So glad to be here. Yeah.

SPEAKER_06 3:06

Awesome. Wow.

SPEAKER_07 3:07

That's cool.

SPEAKER_03 3:08

The resume you have. I'm listening to this and I'm like, we're not worthy.

SPEAKER_07 3:14

No. I'm just joking.

SPEAKER_03 3:17

We we're we're all worthy in some way, but but we don't have we're not in that in that field or anything. Like Jackson has a great resume and everything, but like we're all entertainment and everything, so we're hearing doctorate and all those things, and we're like listen, I've I've worked with doctors, I've worked with PhD students, you know.

SPEAKER_07 3:37

We're everyone's brilliant in our own special way.

SPEAKER_03 3:40

Yeah, yeah.

SPEAKER_07 3:41

Yeah, everyone's got their own little little thing. So I have a I have a question for you. When um you got in it, what was the kind of impetus that got you into these studies? And what did you vocabular? Well, I'm I'm whipping out the the source today. What was the reason you got into um this field in the first place?

SPEAKER_02 4:07

Yeah, I think to some extent you will find that most psychologists and other therapists um and people in across different careers uh have like parts of their personality that naturally draw them to their field or their passion. So I knew that I wanted to be a psychologist since I was in like middle school. Um is wow. Yeah. I'm a person who's like very introspective and curious about the world and people. Um, and I wanted to use those like things that came naturally to me to uh also be able to help people and impact the world, especially a lot of populations who are uh have more difficulty or barriers with access to mental health, um, and seeing mental health as like a foundation for like your total well-being and life health. Um so I pretty much yeah uh went that route and it's been fulfilling so far.

SPEAKER_07 5:16

Amazing with um uh the idea that I I know I'm just editing from over here, I need to stop looking at the screen. So I'm trying trying to give him some uh some feedback, but uh so we're all um this is fully produced by people on spectrum. Uh Terrence Haley and I included. Um you know, maybe at some point in the future this could be a project that could like bring some equity to people on the spectrum, or we get you know 501c, or we do some sort of thing where we can hire people on and actually make it a a media project uh that is like worthy of of that and some fundraising. So that's pretty cool, but I just want to say, um what is from your personal experience, so you got into this um from uh you were very interested in being a clinical psychologist from a young age. Uh yeah, what is what is uh give us a little tale of your your life in New York.

SPEAKER_02 6:21

Yeah, so yeah, my private practice has been in New York the whole time. I do have one clinician working

Why She Chose Psychology

SPEAKER_02 6:28

with me that's also licensed in New Jersey, but pretty much New York. Um I opened my practice in 2018. End of 2018. Questioning. Um, and I think a lot of people uh especially during the uh 2020 lockdown times, had to like sit at home, maybe recognize things or dealt with things about themselves and their families that they previously could distract themselves from. So I got a lot of people coming to therapy then. Um and yeah, since then it's been pretty busy and pretty consistent. Um yeah, like I said, a lot of people come to me for trauma and PTSD work. But I do see a lot of people who um have a range of different concerns and some people who have already either been evaluated and diagnosed with uh different types of neurodivergence or who are curious about that.

SPEAKER_03 7:34

Um, what do you see more often um with diagnoses or presentations of different even different mental illnesses? It doesn't have to particularly be like autism or ADHD or anything, but like what do you see more of?

SPEAKER_02 7:53

Yeah, yeah, I would say the most common uh things that come up, and I think even just like by numbers statistically, um different depressive and anxiety disorders are more common. So, and that can range from like someone uh experiencing like a chronic general anxiety to just like an adjustment kind of period where they're dealing with a lot more anxiety and distress around a life transition, um, and also with some of the mood uh disorders. So you see people who have had like years of chronic uh or multiple um episodes of depression across their lifetime, and sometimes people who are dealing with like different levels of mood dysregulation on a more regular basis, but mood and anxiety things are the most common, I would say. And something along with just like relationship to stress too.

SPEAKER_03 8:59

Yeah, and something um to uh I believe it was my junior year, I was diagnosed with generalized anxiety disorder, you know, put on uh citrulline. Um I've been on the beta blocker for like all the way to now, and uh something I'm curious about is I didn't figure out that I was autistic until like two years ago. And so how does that quite I a lot of people seem to be diagnosed with anxiety and then find out later in life that they're autistic. Um, and I don't know if you've had any findings in that or have had people come in for that or anything or yeah, definitely.

SPEAKER_02 9:50

There have been people who uh, for example, like in their twenties or like past childhood start to get feedback from uh other friends who have already been tested and evaluated and know that they're on the spectrum. And so then that person's friend start telling them, like, hey, have we ever considered or you know, that's us.

SPEAKER_07 10:14

Yeah, yeah. I her her and her uh twin si her and her twin sister, um, I clocked it right away. I like to say that I like am the autism whisperer. But no, I think that it's more um I think that it's more like that you just see these things you you have a sixth sense of you've lived with it and you've lived with the knowledge that you've had it for long enough, you kind of start to um attract those people into your life a little bit, but also you you you see the signs um because it's not as obvious to everyone else. Um so yeah.

SPEAKER_02 10:51

Yeah, and

Practice Growth And 2020 Spike

SPEAKER_02 10:52

uh and I think Oh, sorry. Oh yeah, go ahead. I was gonna say I think I think even with professionals, like in I guess I can only speak from my grad school experience, but knowing my peers now, um, we all learn about we all learn about everything in the DSM. Um and in part of the DSM, there's like all of the developmental um uh conditions and things that are listed there. So everyone learns about uh everything in terms of like a generalist approach. But it is the case that if if you don't necessarily like specialize with a particular population, then some people may be diagnosed late because they may see people who aren't uh experts in that area, and so who are not considering that in their differential diagnosis or not doing testing, um, unless they see something that's on the more obvious end of the spectrum. So it is easier to especially because these things overlap, and there's some features of certain conditions that you see in other presentations that like someone may be presenting with anxiety, but anxiety can happen as a response to many other internal things going on or environmental things going on or developmental things. Um so sometimes, yeah, people uh don't get the the proper attention for a long time until either they notice or other people start noticing that it may be something to consider.

SPEAKER_07 12:44

Do you think that a lot of it gets misdiagnosed as like generalized anxiety, or like one of the things that I s noticed when the way that I try to describe

Most Common Diagnoses Seen

SPEAKER_07 12:56

these disorders to people in a general way, like someone the average population would be that it's like a base layer anxiety. It's not the type of anxiety that you get from external, even though maybe it is stimulation stimulated, yes, but but I would say that like it's coming, it's anxiety built up, but it's lay coming from all different, you know, layers, and as opposed to just being so the way I describe it to people, even though it's not the most accurate way, but is like a um a physical culmination of anxiety or a like um of a way that you show up in the world because of a a layer that is one of the layers is anxiety. Uh, and that's the way I describe it to people because I don't think they people understand beyond that point.

SPEAKER_03 13:47

Because they often are saying they often say, Oh, when you tell them your traits as someone who's autistic or ADHD or something, they're like, Oh, well, everybody has that. Yeah, like, no, there's distinct differences. Um, and can you uh can you kind of go off of that a little bit more as the expert?

SPEAKER_05 14:08

Yeah.

SPEAKER_03 14:08

Um, of like yeah, yeah, yeah.

SPEAKER_02 14:12

I will say that like across um all different kinds of presentations, there's like a hint of truth to the idea that like everyone experiences, but the way that we uh uh communicate through diagnostic um criteria is is also considering that like how does this impact your life or your functioning, whether that's your mood, your social life, your self-concept, your ability to like move around the world and and do things. So it would be like saying to a person who's has like severe depression, like everyone gets sad.

SPEAKER_07 14:55

Yeah, so most of the sadness at some point, but it's not the same.

SPEAKER_02 15:01

So with ADHD, like there's no one in the world who 100% has perfect executive functioning and focuses all the time with no distractions. So yes, everyone experiences distraction, but it's not the same as it interfering with your life and you having to compensate and learn other skills to deal with those kind of things. Yeah. Um, I think it is uh because people have had more access to the language and there's a little bit less stigma now. It's a good thing on one hand because people are developing an understanding of themselves and finding community or finding care if they find therapy helpful. But also, you do have some people who have a little bit of uh anxiety around the idea of the diagnosis. So if they're like finding themselves not able to focus, they they automatically think, like, oh, I must have ADHD. And you complain that like yes, it's a word thrown around a lot.

SPEAKER_03 16:09

It's finals, yeah.

SPEAKER_07 16:10

It's finals

Late Autism Diagnosis And Anxiety

SPEAKER_07 16:11

and you're stressed, exactly. Like that is so um I think that's the reason I think that I've uh described it to people as you know, um it's um it's hard to describe something as severe when it just comes across to other people as as uh quirky, right? So like um like that's what that's one of those things where you just want to like um you wanna find different ways to explain it to them. But at the time at the end of the day, when you over-explain your autism to someone, you're just kind of like not everyone really understands or wants to at least listen to that. Um what do you um so okay, Haley, you're gonna say something about that, or you say no? You don't weren't gonna so I'm just passing it.

SPEAKER_03 17:04

No, I know also nowadays, too, a lot of comedians when they're talking about themselves being autistic, which it is funny to an extent, yeah, but also they're describing it as, oh yeah, let me pick up some rocks. I like these rocks, and like it's making it very um that one girl in school who was um really what what like the what do they call it? What was the term that they used for that girl who was quirky and stuff?

SPEAKER_07 17:33

A tumbler girl?

SPEAKER_03 17:35

Something something like that, and then they're and then later on they're like, oh, she was just awkward.

SPEAKER_07 17:40

No, she just like dinosaurs like the girl likes dinosaurs. No, I think that like that's um so I actually went to a comedy show last night right down the way. It's called Don't Tell Comedy, they do it all around the country, and a comedian came up, and one of his jokes was that he um he he had an autism joke, which I thought was funny, but then he described then he started describing it as um non-emotional. Um like so he described a few things that were like basically like kind of some of the trap the trappings of like what people have general knowledge about. If you were to dispel any major myths about autism in general or any other disorders, what would they be? Well, let's focus in on autism. What would they be if you were to dispel the from your personal experience with your clients, patients? What are the biggest things people get wrong?

SPEAKER_02 18:31

Yeah, yeah. That's a great question. And as you're asking that, I'm thinking of some of the things that um who like people who I've seen in therapy on the spectrum have said themselves. Um I think similar to your uh point about the mix-up with anxiety, a lot of people uh mix up like social anxiety with features of autism. And some people on the spectrum have told me that like it's not like they don't want friends or that they're um wanting to be socially isolated or not like engaged with it, which I think is a stereotype that a lot of people um a lot of people believe. And to some extent, yeah, there may be some people who because of um other characteristics do want more uh alone time or isolation. But but there are a lot of people on the spectrum who want to have connections, um or the or the idea that like there's a complete lack of social skills.

How Misdiagnosis Happens

SPEAKER_02 19:49

I think a lot of the time people on the spectrum are uh trying to manage the cost of like being authentic and maybe socializing in a different way versus needing to do a performance um to maintain relationships and friendships, um, and thinking a lot about like how what is what is the script or what would be the quote unquote normal thing to say or normal way to act.

SPEAKER_03 20:29

Sometimes I definitely and Terrence has said this too, we feel like we don't have the script. And every time I'm at work, I'm like, am I missing something? Because I'm always hyper analyzing how someone's reacting to me. And I'm like, am I not smiling enough? Maybe I need to um maybe I need to animate myself more. I'm just relaxing right now, and they're relaxing too, but then do they not want me to relax? Or and then it does feel like social anxiety at that point.

SPEAKER_07 20:56

I think at that point it's kind of a compensation issue, right? Yeah, using all your cognitive ability to make sure you're not messing up, you know. And I I I do think that yeah, and then that will fuel extra anxiety on top of it. So I think of it as a cyclic uh a cyclical thing, like it's just like it goes in a circle. You start with some general, some underlying anxiety in the situation, then you go to the actual interaction itself, and then it cycles back, you know. And I I think that it's you know, I'm very I came out of my shell a lot more like socially over the years, but I had to really intensely like observe society. I had to I had to look take a deep hard look at civilization.

SPEAKER_03 21:43

The difference with you, Jackson. I noticed is you went up because you were diagnosed when you were young. So you went up. Me and my I have a identical twin sister. Our skills went downhill, we regressed. Um and Do you know uh can you explain regression? Because it doesn't fully make sense to me because I'm like, how can I seem more normal when I was younger and now suddenly we like right now I'm fine, but like sometimes I can't figure out how to do things I used to be able to do. Yeah, am I yeah.

SPEAKER_07 22:24

I don't see that's like that's a personal, you know, that's like okay, thanks, Josh. Yeah, I don't think you regressed.

SPEAKER_03 22:29

All right, whatever. No, I actually did. Yeah.

SPEAKER_07 22:32

Okay. Well, you know, I I do think so that's very, you know, real. So have you seen that in patients where the you know, what do you see the difference of a later diagnosis um on the um personal perception around um spectrum disorders or versus an early diagnosis?

SPEAKER_02 22:54

Yeah, yeah. Yeah, I think one of the most important things and part of the what contributes to people when they get their diagnosis and then the um I guess like the timeline of how that unfolds is the family environment. So someone who was and like social economic conditions too. So someone who is diagnosed really early um had access to those resources because the evaluation and testing is very expensive. Um, I believe depending on your insurance, it's covered for uh younger children, but at some point is not covered anymore. Um so access to those resources, but also attentive parents who were there to observe and uh uh care enough to take them to be evaluated. Um, I often see that people who never got a diagnosis or got their diagnosis really late are sometimes people who come from families who were either not very supportive in general or actively like stigmatized uh whatever behaviors that they were seeing or that they didn't understand, or even like punished those behaviors. So I've had people say, Yeah, my my parents thought I was just a bad kid and throwing tantrums when it was them trying to figure out how to like self-regulate or self-soothe or something. So some people come to find uh or even consider a diagnosis or reaching out when they're away from a toxic family environment and can come to treatment or evaluation on their own later as an adult. Um to your point about the regression, I think that's also um, I can't say in total, but I would imagine that environment has a lot to do with that as well, in terms of how much structure and support are helpful uh as a child. A lot of people are getting like behavioral therapies and different accommodations in school. Um and then when

Myths About Autism Debunked

SPEAKER_02 25:20

they are in environments that are more stressful or high demands or don't have as much structure and support, then some of the skills you may have been practicing and had an environment to reinforce are not there in the same way to support you, you know.

SPEAKER_05 25:36

Okay.

SPEAKER_07 25:37

Yeah, that's um that's that's um the thing you said about uh specifically, you know, this is something we brought up a few times on the podcast about importance of like parental units and and it kind of like uh do they have enough time and resources to take action first and foremost? Like, do they actually have do they live near a major uh city? Do they, you know, um like that was one of the big things back in like the early when I was diagnosed as like 2000 or something? Like, could we get to San Francisco to go to University of San Francisco to go to find a specialist to get a diagnosis? Right? So you have to actually have some sort of like general resources, and then on top of that, a general investment in your kids uh life and and whatnot.

SPEAKER_03 26:33

So um and especially um in my case, my parents were very, very like they did a lot for us, and we were pretty well off. Um they they brought us places, they they just didn't know what autism was supposed like it wasn't as well known for what it was supposed to look like versus what we know about it now. So to them, yeah, we they just thought we for a lot of it we were just um misbehaving in certain ways, you know? Um and they when they took us to see therapists and psychologists, they didn't call it out, so our parents were just like I guess it's just anxiety. Um so yeah, it that's in our specific circumstance and everything. So they did um in our case, they did try to help us. Um and now they're now that they know, like, they're like, oh, a lot things make a lot more sense with you guys.

SPEAKER_07 27:51

Haley and I discussed your specialty when it came to this, and not only just the main focus on spectrum disorders, autism, you know, all the all the chisms, but also the um uh concepts around um uh first generation households and what you know, diagnosis when it comes to that. What is your big like top of the list takeaway that you've learned from your studies in that when it comes to kids uh in the in those families?

SPEAKER_02 28:28

Yeah, I think that what I would say and I remind myself all the time and to other professionals is that like um so I work with a lot of uh children of immigrants as adults, but also immigrant families with children knowing that like they're gonna be the experts on their experience in terms of being able to say where they're coming from and describe what their child's behaviors are like. And they may not have the same exact language, they may not present it in the like jargon clinical way that you may understand things coming um from a western lens or as a clinician, but being having that attitude of cultural humility that like the people I'm sitting with know themselves and they're trusting me enough to share um and taking that in. Also offering um what's coming from your expertise and collaborating together so that you um are offering them the help that they need, but developing an understanding that makes sense for everyone involved. I think sometimes um I think sometimes clinicians can give information, like diagnostic information and things to the families that they're treating in a very kind of like cold and distant and not culturally informed way. Um so that leaves the family even more lost with how to access resources or what are the next steps if there need to be any next steps. So I would say that's my big thing, just having that stance of knowing this family knows their child, they've observed the child every day for their most of their life, uh um, and communicating in a way that both of you are on the same page and understanding.

SPEAKER_07 30:36

Yeah, that's uh so it's a big cultural, you know, difference uh when it comes to how the information is received. Um, do you think it's also potentially sensitive um when I mean, so just from a stigmatized perspective, just a viewpoint on mental health in general from different cultures can be very different from maybe the point we're even at now in the Western world uh when it comes to like at least my generation, millennials and younger perception of mental health issues or diagnoses. Terrence, maybe you can uh allude to this. This

Regression, Support, And Environment

SPEAKER_07 31:15

is an experience you have from uh you have a Haitian, you know, mom and Haitian. Haitian?

SPEAKER_01 31:21

Sir, I'm sir, I'm sir, I'm Jamaican.

SPEAKER_06 31:24

Where are we going with this? Oh my god. Well, uh I'm I'm uh I'm playing it Haitian. It's basically it's like comparing crits in the blood. It's like saying uh Russian, it's like saying it's like it's like saying a Russian is Ukrainian. Exactly, like you don't want to do that.

SPEAKER_01 31:42

The war's been going on for God knows how long. And there's still no resolution.

SPEAKER_07 31:47

We can we can uh we can bloop for this. So um anyway.

SPEAKER_01 31:50

Okay, so um yeah, I I came from um uh two Jamaican immigrant uh parents. Basically, most of them kind of live over here at this point. That's a lie, most they're all over the place, but anywho, um, I was basically the uh quote unquote problem child. Um so I was that kid who would like be a bit of a menace. Um, for example, my very first day of kindergarten uh of uh first grade bit my teacher on the leg and left the mark. Oh, yeah. I don't understand I don't what was what possessed me to do it, but it it happened. Um, especially in in kindergarten, that's where a lot of the chaos started for my mom. Um, I would kind of just say things that I probably shouldn't have. Um, and when one of my teachers tried explaining to her, oh, I think he might be either autistic or somewhere on the spectrum, they wanted to put me on some kind of medicine. I I want to assume it was downers because I was all over the place, and my mom did not want them to do it like at all. It's kind of it was kind of it was it was a huge staple in in uh in Jamaica where they don't take mental health uh all that serious. They take like depression real seriously, or I know that much, but when it comes to like anxiety or ADHD or ADHD or autism or anything like that, it's pretty much thrown under the rug. Um, my family's now starting to get it. Um, my mom especially, but that's only because I started to learn more and more about it. Um other thing that would happen while in kindergarten, uh one of these one morning I was getting on my mom's nerves, and she said that she would throw me under she would throw me into the closet and go to work. And I thought there was a monster in there, and then she uh I went to school, was drawing one day, and then the teacher goes, Terence, what's that? I was like, it's the monster that's gonna get me when my mom locks me in the closet and goes to work.

SPEAKER_07 33:58

Um wait, so um so uh tying this in, so like this is like is this an experience that maybe you've seen uh uh that's relatable to to that experience, or what what of what um I I've heard these stories a lot from like uh immigrant families, from like fam first generation families. Um what is the best way to handle situations like that where you're on the precipice of maybe getting treatment for a kid?

SPEAKER_04 34:34

Yeah, yeah.

SPEAKER_02 34:35

I think aligning with the or or illuminating and then aligning with the parent on shared goals. So the parent may not be ready to absorb all of the information of an ADHD or autism or other developmental diagnosis and what all that means, but but maybe they do want strategies to help their kid regulate. So as you're communicating that to them and like formulating if you're doing a specific treatment plan or intervention, uh um, coming alongside them with what their goals are. So maybe it's like he yells a lot and throws tantrums. I wanna let's get a hold of that, let's like figure out what that's about and reduce that. Um so they're seeing a change that they maybe want to see. You may have more information about the underlying factors contributing to that behavior and all of the like uh clinical knowledge that they that they may not be ready to digest and accept and um embrace. But but you can come together together on starting with where they are and working on some specific goals that will

Culture, Family, And Access Barriers

SPEAKER_02 36:02

that will end up benefiting the child in the in the short term and in the long run. So maybe you are teaching them specific parenting skills and behavioral strategies that that they then see are helpful for them to regulate themselves as a parent to better respond to their child. Um and then maybe they'll be more willing down the line to be curious about and understand the source of some behaviors and also accept that, like if this is an autism spectrum thing, it may not be that the end goal is your child being like every other child. They're gonna have specific um needs that they may need to be uh attended to in a different way, and that may require different things of you as a parent. Um but I think any parent that really loves and cares about their child um will have or the parents that I worked with are eventually open to all right, I see that this clinician can help me with this goal the way I understand it now, you know.

SPEAKER_07 37:10

And how many of the so that's really interesting. I was gonna say most of the time, let's just say there's a the cutoff is the point of medication, meaning that like that they'll willing to do anything except medicate their their child, right? Because a lot of people are, you know, might be against it. What do you um is that something where you like I can't work with them anymore because it's like if it's severe enough we might need to to do that? Or what is what is how do you handle situation where you know they want to go the holistic route or they want to go, you know, um uh you know a certain direction, like like what Terrence was talking about there.

SPEAKER_02 37:54

Yeah, yeah. And I think we the best course of like maintaining a good therapeutic relationship is to fully hear and accept their needs and desires. I I so as a psychologist, I don't personally prescribe medication, but I'm on the more cautious side of when I do recommend someone to see a psychiatrist, for example. I think I think that I'll often I'll often present like uh um different offerings. So, yes, we can try all of the different holistic or behavioral or therapeutic things, and let's set a like realistic goals or a timeline to see uh what's the what are the changes or differences that you want to see, what what is the expectation about the timeline, how much of a difference are you hoping to see? And unless there's no immediate threat in terms of safety that uh requires a higher level of intervention, then let's do all those things, see the progress we make, and then reconsider uh if medication makes sense. I would say too that even when people see a psychiatrist, um a good and ethical psychiatrist is also not necessarily going to like enforce or force anyone to take medication. Your initial intake with a psychiatrist can also just be a consultation to ask questions, they'll get to know some of your history, and they should create a plan too to start with a medication and dose dosage that makes sense, um and have an environment where you can communicate with them about any side effects or um changes or things that need to be made. So I I think you can present it as another tool or option that could be helpful, but that even if someone does take medication, it's most effective when it's something that they see as useful to them because that means that they'll actually take it as it's prescribed, or they will be adherent and take it consistently, you know? Yeah, and I think it's supposed to like a more negative attitude.

SPEAKER_07 40:17

It could be, you know, and it's uh I so I had severe uh Tourette's when I was younger too. So I was also diagnosed with it on the spectrum, but I had severe ticks too. So that was like the thing that overshadowed everything else was my Tourette's, right? And that had to be medicated because I couldn't socialize if I didn't like if I was mosh pitting around in my seat, if I you know I couldn't, you know, function, uh, you know, there's a lot of concerns you couldn't drive, or like there's a lot of things that I wasn't sure I was gonna be able to do, let alone um run a business, but also drive a car, you know, do so there's a lot of questions that arose as a as a child for stuff like that. And um I'm off medication nowadays. I luckily had the type of Tourette's that was uh that did fade away with my kind of body chemistry changing. Um but I would just want to say um just from an overarching perspective, um we we talk a lot about like autism and media, we talk a lot about things related to um the conversations around it. Uh the psychology world, because I know other clinical psychologists actually um doing a tech platform, like I have a tech contract for that ends up facing with people from UCSF, um, from the their whole uh department there. Um it's a super niche world with super niche acronyms, with spo super specific uh forms and lists and everything, right? Um, but like when it comes to the public conversation around this topic, it's hard to break through a lot of the time because you get, you know, what would be the main thing that you would like to say that like should be more part of the general conversation around autism that that might be more unique from your perspective?

SPEAKER_02 42:19

Yeah, as you were talking, I was thinking about your question on misperceptions, and I think that um to the general public, I think there's still this idea that it's something that needs to present in an extreme way that either um someone's on one end completely like non-verbal, um doesn't make any eye contact or socialize, or on another end or in a different place in the spectrum is like uh uh like savant kind of stereotype. Yeah, yeah. I think um representations in the media now seem a little bit more nuanced, but I have also seen people on the spectrum say that like the uh shows that are out there, like the Love on the Spectrum show, um but but more like the fictional

Parenting Goals Before Labels

SPEAKER_02 43:20

characters, not so much reality that that the fictional characters still don't feel like it's a broad enough representation of how much nuance and individuality there is uh with with people on the spectrum.

SPEAKER_07 43:33

Um I don't know if that answers your question, but yeah, yeah, I think that's uh give us a lot of things.

SPEAKER_02 43:41

Uh clarity in terms of the the public facing image of what autism spectrum looks like.

SPEAKER_07 43:50

We have a lot of uh we're we're potential to get some guests that are actually featured on Love on the Spectrum. Um we're in contact with some people and we we do think that like my personal take on it is I do need to watch more of it but I I I think this kind of ties into Tourette's when I watch other people with something that w that I have um it actually flares up all the you know feelings that like are related to it. It's like when you're watching someone with Tourette's you start having uh adopting their ticks. It's a strange feature of that stuff. I don't watch it because of that like a little bit of that but I also think that sometimes it might infantilize the situations where it makes it look kind of cute and I the way that I try to like and it's not a bad thing. Like they're really featuring some cool people on there but it's like the music choices it's my production mindset that's going into that. What um so so for my my my question to you is um that um oh completely lost my train of thought um I was at love on the spectrum uh the the reason that I brought that up you brought it up was um oh my god uh you can do it Jackson no no no the more we talk about if I can do it I'll lose completely is what I was saying. Um so infantilization um yeah so I think that like I understand what it was like growing up with it to feel the kind of internal like pain and suffering part of it I don't think that is actually described a lot. I think that it's the the uh the locked in emotions that is what it feels is a like a person trapped in a person type of feeling that you have is a is an intense feeling of um struggle and suffering and I don't think that's really um noticed or addressed a lot of the time. That's why the depression or things that can kind of come out of those intense feelings and a lot of people because of the way they interact will be like oh they just don't have the same emo they don't have the same emotion. It's like no they're like sometimes it just feels trapped. Um like how do you describe that to people that like don't understand like this is something that is uh a lot of um struggle and like it's not all cute you know how would you um do you have any like reflections on that type of side of it like because it's it is it is you do see every side of it being you know yourself going to see these patients you see like the kind of beauty of it and you see the the struggles that people go through.

SPEAKER_02 46:39

What is what is your um perspective on that I think the average person has a really difficult time doing what we call like mentalizing. So like imagining the mind of another person uh spectrum or not just like one person imagining what it's like to be experiencing the mind of another person. Um so for people who are neurotypical and don't have many barriers to feeling like they can fully feel and understand and express emotions in a socially acceptable way it's hard for them to imagine not having that capacity if they've always had it or always been reinforced socially that they're doing things the correct way. So yeah I sometimes some of the uh uh people on the spectrum that I work with will express like I'm feeling this feeling but I don't know if this is the the way that this is supposed to feel like is this how other people feel feeling this feeling and we'll talk through like let's focus on what you're experiencing now so we can understand what that's like for you whether that's we'll maybe we'll figure out the name of the feeling later but like for example how does your body feel and being able to say like I feel tense or I feel hot or

Medication As One Tool

SPEAKER_02 48:16

I feel jittery or what or what thoughts are associated with the feeling you're feeling um or I've worked with people who feel like some guilt and shame for having uh an intense feeling or worrying about how people will perceive them having the feeling or expressing the feeling so it is definitely a different different experience that um the typical person has a hard time understanding.

SPEAKER_03 48:44

Yeah yeah and I I definitely do feel that a lot for sure. Yeah um guilt and shame the way that it's the way that I said it that made her laugh the guilt and shame of it all shame of everything the drama student um no but every single job I've ever had too um if we're going into that like just the doll it's good he's good it's fine okay okay I'm just giving him looks I'm directing with my eyes which is not good to do with people on spray they won't I'm giving him looks every now and then like that's I feel like people okay now you're distracting me. Now I'm now I'm going no no no no wait okay okay what was I talking about? You were talking about we went from guilt and shame to feelings about uh you talk you're starting to describe something you were getting towards describing something that you were about to talk about if that helps okay let's move on because I lost we we are running close to the we are running close to the end of time so I actually do want to um uh focus in on Haley and conversation because I I need to go let um one of our room members in um just uh Haley ask your question I'm gonna come back in quietly and then rejoin you to finish it off okay okay so don't cut to an empty chair parents if you can help it I'll be right cut to the empty chair we go all right thank you Jackson okay so I guess we'll go back off of um what were you describing before this um we are talking about we were talking about the feeling of the I think you had described it as like the emotions feeling trapped how other people understand that experience or not yeah I know when I was younger and my twin this explains this too is I always felt like we were doing everything wrong but then being told we were doing it right but then people weren't responding the way they were responding to other people and we had trouble keeping friends and we thought that friends were supposed to be like not surface level but then everyone just wanted surface level and so we didn't really fully grasp the concept of friendship honestly most of our lives and so we definitely felt that guilt and shame of like oh there's something we're like I like we're trapped in ourselves and then as we grew older we got closer and closer because we felt we truly understood what was happening um and in our adult life I still feel like we don't have the full script of what's happening at all.

SPEAKER_07 51:51

So yeah I understand like to what Jackson was describing in that um and then yeah and then he's coming back too so I was talking about hi sorry we have a person coming in to assist yeah but uh we were talking about Sarah and I in friendship when we were growing up but about friendships about keeping friends yeah I think um it's one of those I have some weird anomalies about mine of it I didn't have a problem keeping friends but you know over the years they did kind of end up to be slightly more ADHD they also had traits

Media Images And Infantilization

SPEAKER_07 52:38

that were not too far off from mine like just some standard ADHD and just I do think that I just you just attract people into your life that are just a little bit more outcasts like and I don't have the I don't have the atypical friend group I don't have the uh the bros that watch the NFL game every Sunday I don't have like yeah a lot super basic friends a lot of them are artists I don't have a lot of friends who are women most of my friends are guys because I always felt like I wasn't really good at being friends to women I didn't really understand and guys a lot of times felt simpler like they didn't judge me for my reactions to things as much I don't know I judge you all the time wait no I was gonna say differently not in the same way her place sometimes being like yes and this is the um the factual basis of this and this and this which we have a clinical psychologist right I know I know you can rust me but like no I'm giving I'm giving her like an example of something that I experienced yeah yes and like I'm just and then like thinking with you yeah I know I know I'm not I'm no I'm an armchair expert I will say though that speaking of like childhood and peer pressure and things especially in your adolescence for everyone but I imagine it being even more stressful for someone um with neurodivergence or other things that make them different in adolescence you're moving away from the phase where the like your parents and family are the most valuable opinion to you to like extreme pressure to fit into different social groups um or to be not just the norm but to like do certain things that are gonna be reinforced to make you like popular or well liked.

SPEAKER_02 54:38

I think that happens across all gender but there is something about like how we study different types of relational aggression and and women women and teen girls tend to be more on the side of um not necessarily overt explicit physical aggression but some of the things that maybe Haley you're pointing to the relational aggression of like we're gonna you know be mean girls kind of thing.

SPEAKER_07 55:08

Oh yeah no that makes total sense yeah just the the non-physical just the complete mental game mind games are aggression and then I don't understand girl talk I still don't understand girl talking I'm like oh we're gonna yeah yeah of course and I just kind of feel like I'm part of a performance or something like that. Like you're on the wall like you're the tree in the background of the school play we should just talk about really deep things all the time isn't that what we're supp Yeah I think it's much more maybe a sign of also just you crave intellectual stimulation because like at the end of the day um if you are a deep thinker you know you don't want to hear about the fourth like breakup story from the same girl you don't you don't want to hear the same thing over and over again you know I I do yeah but I also still do crave it like I feel very honored when I'm joined like when someone invites me into girl talk and like that just recently happened to me and I was like I get I'm doing something that other people I guess other women do and I'm part of it but then I'm also I still don't understand oh yeah no but here's no I feel I feel great when I'm part like I was at a pool party where there's a lot of like you know they're music producers and like LA LA parties are the place where you could really test if you're on the spectrum like a Beverly Hills party think of me you know you're either going to be a like uh for me I'm very social I am very social I go out there and I do meet people but you're either going to be in my case like a social assassin in conversation or you're going to Yeah it's a hit or a miss for me or or people are gonna really like the fact that you like to talk about these things or you're going to inspire people in some way to get out of their shell. So I hope to say like from my perspective you're inspiring people to get out of their shell and then you also are trying to in some way shape or form understand where to add the punctuation to your sentence right so like those that's a masking part there's like there's there's a part where you're just like full on expression and like creativity in conversation and then there's a part where my brain has to go my face hurts sometimes I'm so hyper aware of what my face is doing that sometimes I feel like my brow is going like is spazzing or something or that my eyes are too closed or yeah he's like start to self-edit or something yeah no I I understand so that's a great yeah parties are a great list lit miss test for that and especially in LA where everyone will judge you um you just have to go you just have to go you just have to dive in and I think at the end of the day I I think living with this thing a long enough time I just stopped really stop caring once you just let go of what anyone else thinks my 30 something odd years in this life just let just the practice of figuring out how to let go I'm also an advocate of maybe be maybe the of like you know meditation for people with autism like things that actually could uplift the spirits of people with and ways to cope or like you know

Feeling Trapped And Mentalizing

SPEAKER_07 58:26

we can close out with that yeah with um you sharing any insight or anything you would like to say about um what could help people you know who are listening to the podcast yeah I think to your point about being yourself um there are some things where like if it really is gonna impair your functioning like you mentioned with Tourette's like not being able to drive because of some of the motor issues and things like that then sure some interventions make sense.

SPEAKER_02 59:00

But I think like there is a lot to be said about if if it feels worth it some people want to like go full blown into like social skills training I want to be able to mask as much as possible and appear quote unquote normal um around things that are not necessarily uh impairments or detrimental outside of like the social judgment of other people.

SPEAKER_07 59:34

And then there are some people who are wanting to work on what is it like for me to be my authentic self and whatever that means wherever they are on the spectrum to not have to perform or mask all the time or to find that community of friends who are gonna be understanding and patient and willing to uh uh hear the different things that they uh uh have particular responses to um I definitely know people nowadays are used to are are more becoming more used to oh you're autistic but when you show your autistic traits then it's not okay it's okay that you're autistic but when you when they see you're autistic yeah it's like oh I think there's a lot more patient people out there I think that maybe that like I it might not be when they it just might be that they're surprised about what how it appears to be yeah it might not be like judging you they just might need be need needing to readjust right so like I think in in any friend group if they're discovering what that means it's it's it is like you know it is what it is right I think that um getting people who say yeah I don't care either way like whatever you have man like like like that's actually good. I actually would prefer someone says I don't care either way and then they just having you rounds chill you know going off a vibes perspective right you just want to have so you know someone that says I don't always want someone who's overly invested in the fact that I have something and even me I don't actually want to be over invested in the fact that I have it and that's where my mentality is is like it's not necessarily masking. I just don't think everyone needs to know and like that's where over the years I started to change my perspective on it's not that I'm ashamed of it. I just need to not um feel like it's a thing that's imp have to impose on people um and I feel like I can blend in enough with my level of of that to do so. And it's okay if you don't blend in though it's okay if I don't blend in because I already have personality traits that don't already like my creativity also doesn't blend in my you know uh stuff that I do on my in my work and art doesn't necessarily blend in. So like everything matches that aesthetic anyway. So I yeah I guess the point I'm trying to piggyback off of what you were saying there is the friend group is really important and um uh but I don't I don't um I also think that it's like yeah I also don't want to feel like um I'm being uh that people are being overly cautious for me.

SPEAKER_03 1:02:29

Sometimes I definitely feel like if I end up s mentioning hey I'm I'm this but it like it if if something happens where I have to say something so that they understand more um in certain situations they are over cautious with like they're starting they're more like I don't know overcompensating for my it's okay you can still treat me like you treated me before no I I mean listen I've had fantasies about pulling out the autism card at the right moment.

SPEAKER_07 1:03:07

At the right moment I have a card right here just just like it's not a fan it's a fantasy that makes to make someone that was treating me horribly to be like red card you know like I got you know you just the last time I did that though they said I was too much and then online said something like you sound like you're on the spectrum like it was supposed to be offensive. Oh yeah yeah well that's the thing is that like we just we just don't like interact with that type of energy anyway. Exactly yeah I I I do think you're still gonna have people and bullies and people out there that see it as like a crutch so I I really I really could care less about what they think. Um I just I just do know that there is a certain level of isolation that a lot of people can feel because of those reasons right because they see a world that is ready to like uh make a make a complete joke out of it.

SPEAKER_03 1:04:00

Yeah hold for siren hold for yeah it's a summer maybe there's another you know yeah but like you're gonna have those experiences not everyone is gonna be understanding and not everyone is going to be um going to have a good heart about it not everyone like like there's different personalities and again also it's not like they're required to stick around for you either. No it could be a passing thing. Yeah exactly and so I guess moving forward from feeling certain ways in relationships um you just have to go with the flow understand that you can't control other people but then that doesn't make it okay for them to treat you certain ways.

SPEAKER_07 1:04:48

Yeah you you can still have a you can still I think I'm proof that you can still have a backbone and have autism. You can still be able to be ready to have the tools to confront people and stuff like that.

SPEAKER_03 1:05:00

Going back to all those stigmas about autism right uh people who are autistic aren't necessarily like you're not devoid of emotion so you actually sometimes have too much emotion. Yeah um you're not unable to fully read people you just sometimes you read my uh like micro expressions like and then there are there are different there are different like if you meet an autistic person that's one autistic person everyone's different like it doesn't magically mean that you know what autism is so and I think that you know we live in the WebMD world we would live in a wiki kind of world yeah like let's think no I think that like yeah it's like hey chat GPT like tell me about you know this one thing about autism no I I think that we you know I I I honestly think the stigma in relation to it is getting like things are getting better um and you know there's more conversations had about it online your discourse is Gen Z and

SPEAKER_07 1:06:00

Gen Alpha. So our podcast is, I feel like, going to um, you know, hit the market with a lot more people like that. Uh what would you say, you know? This is what I think a good final question. Yeah, yeah, final question. This ties it into your like whole area of expertise. Um this is like um

Friendship Scripts And Masking

SPEAKER_07 1:06:20

the thing was like self-diagnosis through like means of like you know, social media and TikTok and like no personal relationship to it. Uh give us the uh there's an understanding uh that's you know we're empathetic to the fact that if you self-diagnose, it's just because you don't have the resources to go and get and seek help. Um and this ties into access to uh healthcare, to uh psychiatric, you know, needs. Um what um what what is your take on self-diagnosis and then what is the solution that you would say to someone who's like, I don't really know where to start, what to do, like what am I even doing? So what's your advice to them? Where am I? Yeah, where am I? Yeah.

SPEAKER_02 1:07:07

Yeah, yeah. So I'll start by saying that I think most people um who end up kind of like doing their own review of the literature online or review of different experiences and have a formulation about themselves or a self-diagnosis, are probably coming from it with like a genuine curiosity or sometimes with distress in trying to understand what their experience means, trying to like have a name for it. Um a lot of people because so testing is so expensive because like the different questionnaires and testing materials themselves are expensive. Like nine and then doing the testing or the evaluation, not just like the it's not just the cost of that session or a few sessions, but the time that it takes the psychologist or psychiatrist to um score and evaluate and interpret all of the measures and then differential diagnosis and rule out other things. So there's a lot more that goes into the more standardized evaluation and assessment process um that makes it so that there are cost barriers and time barriers too, and uh a bunch of different access barriers that not everyone has thousands of dollars to go and see a professional and all those things. So definitely people who are um self-diagnosing are probably coming from a genuine place of curiosity. I would say though, like have an idea or try to develop an idea of what is this diagnosis going to mean to you. So people have different attitudes toward diagnoses. For some people, it's okay, this is a new framework that I can have language for to understand myself. For some people, it's all right, this is gonna help be the tool to get me in community with other people who have this same experience. Um for some people it may need to be the more formal route because they do want particular accommodations for school or work or uh access to medications or different things. Um I would say that as you if you're someone who doesn't have access and you're thinking through uh uh and self-diagnosing in your head that like focus on the goal of understanding what your experience is, yeah, and not necessarily what it will mean to have the label per se. Because you're still you, you've been you the whole time, and you've been having these experiences internally or behaviors or social interactions, and and if that helps you get a better understanding, then sure.

SPEAKER_03 1:10:16

I know it changed my life.

SPEAKER_02 1:10:18

But it could be helpful to clarify with a professional whether there are other other explanations. So for example, um someone may have uh difficulty with focus and attention, but it's specifically when it's like verbal. So they may have like an auditory processing thing and not ADHD. Or someone else may have like a specific reading learning disability and not, you know. And so it's the help of a professional to do those like differentials um can be valuable, but definitely understand people wanting to uh know and understand their experience and have language for it.

SPEAKER_07 1:11:03

Yeah. No, that's an incredible uh answer. Yeah, thank you so much.

SPEAKER_03 1:11:08

I got a little emotional with sexual.

SPEAKER_07 1:11:10

Oh, I noticed I saw the tear tear ducks going. Whatever.

SPEAKER_03 1:11:13

I think that's cry.

SPEAKER_07 1:11:14

No, you're allowed, you're loud. No, I think the um uh yeah, the things you said about, you know, uh people's reasoning and you know the uh the the that you're basically still the same person after uh you know, I think it's gonna be really helpful for people to hear because that's like it's very true. It's you know, it's you don't you don't change because your diagnosis you uh unlock some potential for you know treatment or otherwise, but definitely I think that can unlock a lot of like people's t distress around receiving a diagnosis.

SPEAKER_03 1:11:49

So yeah, definitely on my end and Terrence's end. We um simply not just being on the spectrum, nothing like that, but simply starting to be able to understand how we work, we unlock so much more potential in ourselves. Yeah, yeah. And I have to work with these two. And Terrence, right?

SPEAKER_07 1:12:09

And I have to work with these two, so I know the whole thing.

SPEAKER_03 1:12:12

Yeah, I know. Thank you. I had to take something sincere and definitely completely and utterly changed my life.

SPEAKER_07 1:12:20

Yeah, no, and it did, and I think every single part of it unlocked something, but it unlocked your ability to really understand yourself in new ways. So I think it's pretty awesome. Well, um, Mercedes, it was so wonderful to have you. Is there anything else you want to talk about or plug before we like sign off?

SPEAKER_03 1:12:39

Um like your your services or anything.

SPEAKER_02 1:12:44

Yeah. So

Parties, Performance, And Letting Go

SPEAKER_02 1:12:46

if any of your listeners are in New York, um, they can find me in private practice. You can search my name, Mercedes Okosi, um, or look up growth work psychology. Um, I'm on all of the like psychology today and my website and everything. Um, I have a couple of books that are available. So I have a journal for complex PTSD. You can find on Amazon. Um, I'll send you all the links to these things so you can share. Um, I have another journal that's specific to black women's mental health. And I have a speaking of boundaries, um a book coming up soon for people who struggle with boundaries. There's some anecdotes and then skills and uh resources to communicate assertively and work on boundaries. So awesome. Yeah, nice thankful for you all having me.

SPEAKER_07 1:13:49

We're so glad to have you as well as very wonderful conversation. Yeah, and um, yeah, we um feel free to to check in with us anytime. Um, you're not a friend of the podcast, so um we might we might you are a friend of the pod now. You you uh you're gonna make it to the wall, maybe we'll put you up on the podcast. But on the wall, we have much photos. So uh yeah, well, thank you so much, and we're gonna we'll wrap it up. But uh it was so nice to uh to see you here.

SPEAKER_03 1:14:17

Thank you, Dr. Mercedes Ekosi. You're amazing, and we will hope to speak to you soon. See you soon. Um, and bye.

SPEAKER_07 1:14:26

Bye. It was nice to see you. Hey all, thank you so much for joining the NeuroFucked Podcast. We'd love you to hit subscribe, like, comment, find us on your favorite podcasting network. And we just love that you're here to share this experience with us.

SPEAKER_03 1:14:41

Thank you so, so, so, so much for joining us and for listening in. We appreciate all of you guys. Please stay, join us for the next coming episodes, join us for the future of whatever this podcast may hold.

SPEAKER_07 1:14:55

You are the future, and we'll be there. We'll be your future, and we'll love you to the end of time. Not in that way, but like in a very friendly, kind, loving way.

SPEAKER_03 1:15:08

My smile really actually hurts right now. It started shaking in the corner.

SPEAKER_07 1:15:14

We need to end this all. Let's go. Okay, bye.