Dissociation, anxiety and the power of felt safety with Stephanie Robertson

Laetitia: Welcome to Neurodivergent Pulse, where we explore the often misunderstood world of neurodivergence with experts, parents, teachers, and therapists. Grounded in lived experience, each bite sized episode gives you something practical to try. I am your host, Laetitia Andrac, AI expert, neurodivergent mum, and founder of Understanding Zoe.

Laetitia: This podcast is recorded on Dharawal country. I acknowledge that sovereignty was never ceded. It always was, and always will be Aboriginal land.

Laetitia: Hello, Stef. We are finally recording this podcast. Welcome to the Neurodivergent Pulse podcast.

Stephanie: Thank you so much for having me. This is very exciting.

Laetitia: It is going to be a wonderful conversation about dissociation and anxiety.

Laetitia: Before we get into the nitty gritty of our conversation, I would love to give you the opportunity for you to share who you are and what you do. And I have finally met you in person this year, and it was an absolute joy to meet you in person after having been one of the heavy consumer of your contents and your voice on Instagram and your website.

Laetitia: So thank you so much for making the time. But for anyone who doesn't know you, can you share a bit more about who you are and what you do?

Stephanie: Yeah. Well, thank you for that. It was so lovely to meet you as well. I am Stef. I'm an occupational therapist. I have been working in this space for over a decade now.

Stephanie: I have history in research as well, having done my master's degree. I have a real passion for neurodiversity affirming practice, and the neurodiversity affirming paradigm, and really looking at concepts like neuronormativity, who decides what constitutes as normal or our baseline, and how do we allow people to live this human experience in line with what feels right and embodied and grounded for them.

Stephanie: I'm also part of a plural system, which is where my interest in dissociation comes in and from my lived experience as well as my work experience and training and stuff like that as well. Outside of that, I am a mum to a gorgeous 15-year-old daughter who is an absolute legend. She'd be embarrassed if she heard me say that.

Stephanie: And a book lover, an animal lover, and self-confessed weirdo. That probably sums it up.

Laetitia: I love it. Oh my gosh. So beautiful. And there are so many elements where I feel a deep connection with your special interest. So something I'd like to deep dive quickly now is, as I've done my own research, you've said that before your own identifications, that you thought, "I'm not disabled enough to be autistic."

Laetitia: What changed, and what did understanding yourself made possible?

Stephanie: It's a big question, and I think the easiest way that I can answer it is to say that I had one of those very common stories of gathering diagnoses in the mental health sector because, of course, AFAB people or girls don't have autism, inverted commas. So, I got all of the mental health diagnoses to try to explain away my challenges.

Stephanie: And so even for myself, and this is what I find really interesting and I'm still unpacking, even though I worked in this space, as a paediatric occupational therapist, my daughter was diagnosed, identified autistic when she was five. So I had so much experience, and yet I still had so much internalised ableism that I didn't apply the same considerations to myself.

Stephanie: I sort of thought, "If I take the right medication, if I just try harder, be a better person, I won't have these challenges." And then eventually, when I started seeing more people who were late identified women, or AFAB humans coming out about their experience and hearing the narrative that they had also gotten the depression, the bipolar, the anxiety, all these collection of diagnoses, I thought, "Okay."

Stephanie: It's almost like I needed someone else to shine the light in the right direction for me to sort of think, "Oh, this could be me, too." And that's when I explored it and was very quickly identified as being autistic ADHD. And it allowed me to just breathe for a second because I felt like it wasn't, there wasn't something wrong with me because I was already so aligned with the neurodiversity affirming paradigm.

Stephanie: And interestingly, I hadn't been able to sort of give myself the same, what's the word I'm looking for, grace around mental health because, and my views on this have changed obviously over the last decade, but at the time I sort of thought I could try harder my way through my mental health stuff.

Stephanie: I didn't affirm my own experience, whereas something about being autistic and because I knew so much about it and it, I'd nerded out on it so much in my special interest in my work, it just felt like it all clicked into place and I belonged. It's so hard to explain, but I just felt like everything made sense.

Stephanie: And then when I reflected back on my childhood, my challenges, spoke to my parents more about things, everything just fell into place. And then I, yeah, I guess once I was able to start looking at myself through a different lens, everything changed. I was able to really start creating a life that worked for me.

Stephanie: And if I look at where I am now compared to where I was 10 years ago, it really is a huge difference.

Laetitia: Wow. Everything you said, I was like, "Oh my gosh, I could really see my own lived experience in some way." You know, as you said, the collection of mental health assessments, and this internalised ableism, and then this coming full circle and this deep radical acceptance of what has happened early on and what has been happening in the last few decades and what is happening now.

Laetitia: Like, so much beauty, in what you shared. And so now if we double down on the topic of dissociation and anxiety, I am going to quote something that you've said, which I think is really powerful, which is, "The trauma isn't the event. The trauma is how the body adapts post the event."

Laetitia: And I think that one sentence change how we interpret and read things for a child or for a teenager or for an adult. So can you unpack a bit more about this for our listeners?

Stephanie: Yeah, absolutely. I remember when I first learnt about this, I was doing some work with SACASA, which is actually an organisation that works with children who have been the victims of sexual assault.

Stephanie: And through them I learnt that data showed that children who experienced trauma, like a specific traumatic event, or what could be labelled a traumatic event, how they would go on to develop, say, C-PTSD or any other sort of ongoing challenge where the trauma is embedded in the body depended a lot on how they were responded to.

Stephanie: So it wasn't the actual event. It was how they were supported, affirmed, all of that post the event, right? And this is what really got me curious about how trauma works. So depending on a nervous system and how vulnerable they are, something may become a trauma to that nervous system and that body that may not for someone else, and this is why it's so important for us to recognise that it's not the event, and it's also not our place as, say, the adult, the therapist, the whatever, to decide what might then become traumatic for someone else.

Stephanie: There are a lot of children who have experienced trauma that they will carry for most of their lives from school, for example, whereas other people go off to school, have a wonderful time, get on with their life, everything's fine. So it's really looking at the really intricate interplay of that individual, their personality, their nervous system, their needs, their neurotype, then the events, the environment, what happens after the event, how they are supported, and that is what then can kind of give us what could become something that becomes a trauma that that person lives with and is managing versus not, you know?

Laetitia: So important, because I think for many people listening to this gives them permission to just accept that something that they feel is not a trauma can be a traumatic experience for someone else. And the other way around, where some people are judging and be like, "Oh my gosh, this is so traumatic," when actually, if they were well supported in the right environments with the right context and so on, they kind of lived it in a different way.

Laetitia: So I love what you just shared. You wanna add something to this before I move to the next question?

Stephanie: No, I don't think so. I think you summed it up really beautifully, and I think that is the point, right?

Stephanie: That when we see, if we see a child, for example, responding in the ways that we might see if they've experienced a trauma, changes in behaviour, becoming withdrawn, there's a whole host of things, we just need to take it on face value. We don't have to think, "Oh, it can't be that because there's been no big trauma."

Stephanie: They often call it a big T trauma. Like the traffic accident or the death of a loved one. But it can be these sort of microtraumas or these small T traumas that compound and cause these things as well. And if we just start seeing this, it's okay for us to go, "This might be what we're seeing. Let's just address it."

Laetitia: Love it. So, there is this word dissociation, which some may be familiar with, some may haven't been really trained or, like, haven't crossed that before. So what do we mean by dissociation, and why does dissociation exist? What is it protecting the person from?

Stephanie: I love this question because I do think dissociation is something that doesn't get spoken about enough, particularly in the area of children and paediatrics. And dissociation is a very normal, natural, healthy response and thing that the brain can do. We all dissociate at some point. We're not always present in the moment.

Stephanie: So dissociation sort of exists on a spectrum. At one end, you've got daydreaming and sort of zoning out or, when you drive from point A to point B, and then you realise that you don't quite remember the drive, those sorts of things. And then as we move up the spectrum, we get into diagnosable dissociative disorders where people might have separate identity states, or they have dissociative amnesia.

Stephanie: There's depersonalisation, which is a sense of not recognising your own self or your body. Derealisation is a sense of not recognising the world around you and the environments that you're in, feeling like you're in an altered reality. And these become diagnosable because they become challenging and actually start impacting someone's day to day life, and this is where that spectrum occurs.

Stephanie: And someone can move up and down it. I certainly do as someone with a diagnosed dissociative condition. I think it's important to recognise because there is no doubt that children dissociate. You get those kiddos in the class that are looking out the window, they're daydreaming, whatever.

Stephanie: But also, when it starts to become challenging for them, it can be those kiddos that are really shutting down. Dissociation really is the core survival mechanism that comes in. We get our freeze, fight, flight, flop. This is dissociation coming in. It's like, let's shut everything down because we can't fight our way out of this.

Stephanie: We can't flee our way out of this. So we're gonna actually get the brain to just separate from the body almost to keep it safe. And it's an incredible phenomenological thing that the brain can do. But I do think it's important to recognise that this is happening for kiddos too.

Laetitia: And what may be happening in their nervous system in that moment that the adult around them may not see or can't see?

Stephanie: Yeah. So it's probably highly activated, right? And most likely in a fear response. Dissociation to that extent, especially if it's linked to trauma and things like that, often will come into play because in that moment it feels like the only option for survival.

Stephanie: We also know now through research that autistic and ADHD brains are more likely to use dissociation as a coping strategy than allistic or non ADHD and autistic brains.

Stephanie: So you might see a child who seems to be very, very calm. They might be, for example, in a school setting, they might be following everyone else, getting their lunchbox, coming and sitting down. They're sort of going under the radar, but that little human could be experiencing an element of dissociation because their nervous system has got to a point where it's so activated that it's just separating itself from reality.

Stephanie: So I think it is a really tricky one to pinpoint and to pick up on and to say that's exactly what's happening, especially because the way we understand dissociation, a lot of it does come from someone being able to report their experience of derealisation, for example, or depersonalisation, et cetera.

Stephanie: It's harder with children. But there are assessments and stuff now to look at dissociation in children, which is fantastic.

Laetitia: So, what can one do, and this is not a question I prepared for you, it's just I'm curious. I'm getting curious. What can one do to support a child or a young adult or an adult when they witness them going into the response of dissociation, to support them through that experience?

Laetitia: And, you know, intuitively we may wanna bring them back into the present, but actually this is a state that feels good for them at that point in time. Again, not being an expert in the field, just having lived experience of dissociation as a survival mechanism. I wouldn't like someone bringing me back, being like, "Hey, hey. Stay here."

Laetitia: So what could we, what could one do to support someone through the dissociative state?

Stephanie: Yeah. That's a really lovely question because, you know, like you just said, you've experienced it, I've experienced it. I think one of the best things we can do is if we recognise the dissociation is occurring as a result of the nervous system feeling unsafe, the best thing we can do is offer felt safety.

Stephanie: So it's a case of allowing them to be in that slightly different state, that dissociative state, but it might be bringing them a comfort item. It might be offering a safe food. It might be just sitting next to and having a parallel play engagement, reminding that person that you're not going anywhere and you're here if they need anything.

Stephanie: If it's someone who gets comfort out of deep pressure, offering them a hug. Looking at generally someone's sensory preferences, what they find regulating, and removing anything that is dysregulating. But I think the co-regulation piece here is really beautiful because when we are co-regulating, we are organically sort of brought back into the body in order to share in that connection with another human.

Stephanie: So what it does is it offers security by saying, "I'm here with you, but I'm not trying to get in and change how you are. I'm just offering that support." And it invites them to sort of settle back and reconnect when they're ready. And often what I've found in my work with children who experience this state is that when I just enter the space on that sort of parallel level, usually they are distracted out of the dissociative state naturally once we start exploring something that is joyful for them or a special interest or something like that.

Stephanie: So you can kind of offer something that feels safe, feels like it's them, they've got autonomy or agency over that thing, so that helps with the safety piece, and that can bring them down into connecting. And then that's when it opens space for us to talk about how does it feel when you feel like that?

Stephanie: What feels right to you when you feel like that? Do you like it or do you dislike it? And just get really curious about what feels right for the individual.

Laetitia: Wow. So gentle and so supportive. I really like it. And so affirming. I really wish lots of people will listen to this and just get curious and support this way, especially thinking about context when a child is maybe in a social group or in a classroom or when you as an adult are in a party or a place where actually dissociation may be the way forward.

Laetitia: There is something I really wanna ask you, and this is for you to share as much as you want and as little as you want, which is you bring this topic around dissociation and anxiety from a lived experience, not just as a clinician. And you've spoken about growing up masking and how it wasn't safe to feel the feel of life.

Laetitia: So I would love for you to share a bit more about when did you begin to understand what your mind has been doing to protect you and your own lived experience of dissociation and anxiety. And as I said, you go as deep or as shallow as you want.

Stephanie: So I, and I will probably answer this question using we rather than I.

Stephanie: I often use we when I'm sharing things that affect multiple parts of our system, multiple identity states. So we've always experienced anxiety and knew that, right? So for as long as we can remember, anxiety was just sort of there. And to this day, it still is. I don't know whether we'll ever reach a state where we exist without anxiety.

Stephanie: It's almost like the monkey on your back that becomes a friend. But dissociation was very different because the very nature of it is that it protects you from knowing about, in a lot of cases, something that's been really hard. So interestingly, up until probably mid-20s, we thought that we had a wonderful childhood and that nothing awful had ever happened, and all these things because that is how the brain created that we would hold certain memories and only those, and we would only have access to those, and we would create this timeline that was awfully scattered, but who knows?

Stephanie: And, you know, have this beautiful story. But then there were a few things that, traumas that had occurred through adolescence that we did remember. And so we put everything that we struggled with down to those things that occurred in adolescence. So we went and sought assessment and intervention through a trauma informed therapist.

Stephanie: And it was through the incredible work, we still see the same therapist nearly a decade later, and it was through her incredible work she began to very gently notice that there were actually altered states. So she felt that she was actually talking to different parts of our system at different times as we were unpacking trauma, and some of those parts knew about things from childhood that, say, I, Stef, didn't know about.

Stephanie: And to this day still don't know about. I'm still very sheltered. The system keeps me as the going on with daily life part and, while I know some things, I certainly don't have access to the feelings associated with some events that have occurred. And so it was very interesting to have the psychologist suggest to me that they would like me to complete this assessment, which was the MID 60, which is an assessment of dissociation, and I was like, "Oh, okay," just going along with it.

Stephanie: And then the results came back and it was very, very clear that we met criteria for dissociative disorders and things like that. And it just opened this discussion. And I think it was simply that other parts of our system whose job it had been to keep me separate from a lot of that so that I could go on with life decided that it was safe enough to start exploring and for me to start knowing stuff.

Stephanie: And so gradually, and back then only when in therapy, parts would make themselves known to me. I would get to sort of meet them and understand what their experience has been or whatever. And now more so we have developed over about a decade an internal communication and dialogue and that kind of thing.

Stephanie: I'm not sure if that fully answered the question, but.

Laetitia: Completely. Thank you so much first for sharing, and I have witnessed you sharing about we in the past, and I find it's very powerful. I have been personally working a lot with psychodrama therapy, which is a lot about getting to know your system and the parts, and it's a group therapy that I absolutely love, and I've trained in for the last three and a half years.

Laetitia: And it's become a special interest of mine, and definitely I have seen the impact of those different parts holding some information. And being friends with those parts and getting to know them and getting curious is a very powerful work when you find the right supports to go through that because you need a deep sense of safety to explore that. So thank you so much for sharing that.

Stephanie: For sure, yes. It's really potent. Really love it.

Laetitia: So I just wanna go into now, for the carers, for those who are either parents or teachers or therapists, and they're here to support those individual going through this.

Laetitia: And you've said in the past we were not designed to parent or raise young children alone. So what does a real village look like for a family living with anxiety and dissociation, whether it's the kiddos, whether it's the adult experiencing it? What could that look like? What could one build around them?

Stephanie: And this is a tricky question because I feel like I know what it could look like, and yet I don't know whether our societal systems and structures right now make this easy to do. I still think that Western culture and Western individualised independence based culture means that we have been pushed away from community, and from feeling that we can accept help or be supported by others without it needing to be a transactional experience, and those sorts of things.

Stephanie: But if we dream a little, I would love to see parents being able to support one another in communities where support swapping can occur. So for example, if one person finds it really easy to do laundry for example, while another person finds cooking to be easier. Finding people where you can support swap with, "I'll do a load of laundry for you, I'll cook a meal for you."

Stephanie: And it becomes interdependence, right? Where we're actually allowing ourselves to rely on other human beings for support. But of course, there needs to be a felt safety there and a trust coming back that that person is going to continue to be there. I think that especially when we're raising neurodivergent children, having community that are also in the same boat so that you have a sense of connectedness, neurokin, is so powerful.

Stephanie: Both for children to grow up with others who have their similar experiences and to help combat stigma, but also to feel seen. I think there's an experience in humanness, and I feel like I could go down that rabbit hole on a very spiritual element for a long time as well, but we want to be seen.

Stephanie: Humans want to be recognised in their essence in some way. And I think when we walk alongside others who are experiencing the same thing, even if it doesn't change the reality or how hard it is, it can ease the burden of isolation.

Stephanie: And that can be a protective factor as well. So I think there's an element, and again, I teeter on whether I agree with what I'm about to say or not, but, in being vulnerable enough that you allow someone to see you so that you can create that connection, I think that can be really important. And at the same time, I recognise that being vulnerable can feel very scary and unsafe, and therefore you don't wanna do it.

Stephanie: So that's kind of the point I was trying to make there.

Laetitia: Yeah. And I was getting weirdly emotional when you shared that because I think, in our own lived experience, we are a family of four living 24 hours away from home, and making new friends and allowing them, oh my gosh, I'm really emotional, to see us going through what we go through, and inviting them in and asking for support took me many, many years.

Laetitia: But I know that now that I'm doing it, being on the other side of the discomfort of feeling unsafe and opening up made such a huge difference. Feeling comfortable now to message a handful of people when I need help is game changing. Whereas if I had stayed in France, I had potentially a deeper network of people where I was already, I would've been already safe to ask for this.

Laetitia: So really sharing from being on the other side and dealing with this dilemma of is it safe for me to invite them in for them to witness this so that they can help, and I feel safe to ask them for help. So yes, that was so beautiful. So before I let you go, I have one more line that you've shared that I really wanna ask you the question about.

Laetitia: I'm sorry, we're going a bit over time with this one, but it's so gold that I wanna keep you here. Um, you said if a plant, and I love gardening analogy. I wrote a lot in my book about intuition and how gardening and cyclical living is something we need to reclaim, as you were sharing about spiritual things. I feel safe to share a bit more about that. But if a plant is not growing, you don't change the plant. You change the pot, and its soil, and its light, and its water. So for anyone who is listening to this right now, and may be experiencing dissociation and anxiety, or may be supporting someone who is experiencing dissociation and anxiety, what is one thing in the pot they could do that will change this week, or something they could try?

Laetitia: And I know when I ask this question you're gonna be like, "Oh my goodness, it's so hard to say one thing." Whatever you've, based on your own lived experience and just what you offer, what could be something someone can try?

Stephanie: I think one of the most accessible things that we can do is recognise that all human emotions, so, or experiences, whether it's anger, dissociation, fear, sadness, they have a place and they're there for a reason. They help keep us safe. They help keep us alive. And I think, again, in Western sort of colonial healthcare, we have seen wellness be put down to happiness or calmness, or all these things, when in actual fact, the whole host of human emotions are there for a reason.

Stephanie: And in looking at that reason, there will be something within the pot or the environment that is causing this response. So what I invite people to do is when they see any of these things, rather than feeling in a real hurry to change it, which is often how people feel because witnessing their loved one, particularly a child, experiencing a distressing emotion or being very dissociated or zoned out or highly anxious, is distressing for us.

Stephanie: We wanna change that. We wanna fix it, and that's natural. But if you can sit for a moment and go, "I'm just gonna ride this with you. I'm gonna be with you in it. We're gonna allow this to be experienced because it is valid, because it is in response to the pot being wrong," even in that, we have actually changed the pot, because we've changed the interpersonal environment that that person is experiencing this in.

Stephanie: We're actually contributing to felt safety within that environment now. And then we can start looking at the more practical things like, is the sensory environment wrong? Do we need to change the light? Do we need to change the clothing, the temperature, anything like that, right? But when we change that interpersonal context initially, that's, I think, where we make the biggest difference.

Laetitia: Wow. Thank you. Very good. So last question, and then I promise I'll let you go. But I like this pass it forward concept. So before we close, what would you want to say to someone who is right at the beginning of the road you walked? What do you wanna share with them?

Stephanie: There is nothing wrong with you. You have a unique energetic frequency or humanness about you that exists for a reason, and you have something to offer the world. And even if things feel really hard, I have no doubt that there are wonderful things about you that deserve to be seen. And when we give ourselves enough space to explore what we need to allow those things, whether it's the thing you love to nerd out about or the thing that brings you joy or something that you're really good at that people might find a little unusual, but that is your you-ness, right?

Stephanie: And that's what we need to allow to shine. So I would say I know how hard it feels, how dark it feels and lonely and the crushing weight of everyone's expectations and all those other things. But there are people who will see you for that essence that you have, and I think that in itself can be really healing.

Stephanie: So finding your neurokin, giving yourself space to just be you, even if it's in the privacy of your own home where you can unmask and start exploring what feels good, and then making space for more of that. And then hopefully eventually recreating, whether it's your workplace, whether it's your social connections, to have new boundaries, a new set of rules about who gets access to you and what kind of support and respect you deserve.

Laetitia: Wonderful. Thank you so much, Steph. So if anyone would like to find out more about you and your work and go down the rabbit hole of consuming lots of your content, which is always gold, where can they follow you, find your work? And of course, we'll link all of this in the show notes.

Stephanie: Yeah, so, my Instagram is just, at S G R Occupational Therapy.

Stephanie: I named my business that because I wasn't very creative, so I went with my initials and I thought, "Well, that'll stick." My website is www.sgroccupationaltherapy.com. I do have a podcast called Alphabet Soup: Exploring Complex Neurodiversity, where I just talk about random things that come into my head, honestly, or talk with other cool people.

Stephanie: And yeah, then Facebook, it's all the same name. I'm on Facebook as well. That's where I post most things, I think.

Laetitia: Thank you.

Stephanie: I might have forgotten something, but we'll chuck it in the notes.

Laetitia: Yeah, we'll put everything in the notes. Thank you so much, Steph, for today, for sharing so beautifully about your lived experience and your expertise around this topic.

Stephanie: Thank you so much for having me. It was such a pleasure.

Laetitia: Hello, Zoe. Welcome to another Neurodivergent Pulse. I would love to hear from you, because it's your Zoe's Pulse, how, what is supporting you when you are feeling anxious?

Zoe: You, Dad, and Lou mostly support me, and sometimes Cookie comes to me tons of times when he knows that I feel anxious about stuff. And yeah.

Laetitia: So are there people supporting you?

Zoe: Yes, that supports me.

Laetitia: That supports you. And Cookie's your dog, right?

Zoe: Yeah.

Laetitia: So how do you support yourself when you're anxious at school then?

Zoe: Well, I think that I just take deep breaths and I try not to think about it.

Laetitia: Okay. Anything else that helps you in those moments of anxiety?

Zoe: Well, sometimes I bring fidget to schools, does help me too. And time to time I talk to my teacher. She helps me most of the time.

Laetitia: Thank you, Zoe, for sharing. Anything else you wanna say to anyone who is feeling anxious sometimes?

Zoe: Maybe just try not to think about it, and try and think about other things that's awaiting you.

Laetitia: Thank you so much, Zoe.

Zoe: Bye.

Laetitia: Bye.

Laetitia: That's a wrap for Neurodivergent Pulse. If this helped, follow the show and leave us a quick review on your favourite platform. You can even share this episode with someone who needs it.

Laetitia: You can learn more about our platform at understandingzoe.com. Thanks for listening.