Authors: Hilary Smith, Laurence Cobbaert, Anna Rose & Emma Spiel,
Event: 2023 The MHS conference - Adelaide
Subject: Radically rethinking neuronormative interventions in mental health and disordered eating, and eating disorders
Type of resource: Conference Presentations and Papers
Whilst eating disorders have been estimated to affect at least 4% of the Australian population (1), research suggests that eating disorders are overrepresented in neurodivergent people, including in autism (2, 3, 4, 5, 6, 7, 17), attention deficit hyperactivity disorder (4, 8, 9, 10, 11, 17), intellectual disability (12, 13), giftedness (14, 15, 16), and Tourette’s syndrome (17, 18).
In addition, eating disorders and body image concerns have been shown to affect and manifest differently in neurodivergent people compared to their neurotypical counterparts. A variety of unique stressors and factors have been identified, such as minority stress, masking, the double empathy problem, and sensory processing. Unfortunately, current therapy frameworks do not adequately address and accommodate the support needs of many neurodivergent people affected by eating disorders (20, 21, 22, 23).
The National Eating Disorders Collaboration (NEDC) commissioned a report from Eating Disorders Neurodiversity Australia (EDNA) that aims to support and guide mental health sector stakeholders to co-produce neurodiversity-affirming prevention and support systems in collaboration with the neurodivergent community. It is this report that will serve as the basis for the workshop (25).
The workshop aims to engage attendees in a radical rethink of how neuronormative feeding and eating practices may prove harmful for neurodivergent people (19, 20, 21, 22, 23, 24), and to consider ways of working that both assist people to move way from their eating disorder behaviours whilst also tending to important sensory, emotional and psychological needs. Activities will endeavour to assist attendees in being better equipped to understand and adapt accordingly to meet the support needs of neurodivergent people affected by eating disorders.
15 minute activity - Setting up for safety. The group will be engaged in an activity designed to set up safety for all workshop participants. This will develop skills and understanding about ways to set up a safe space for neurodivergent individuals within their own practice. An explanation of sensory meltdowns and shutdowns will also be provided to highlight the importance of sensory safe spaces.
30 minute presentation and Q&A - Theoretical and empirical underpinnings of radical rethinking. Attendees will be introduced to the Eating Disorders and Neurodivergence report (25) and provided an overview of how specific factors associated with neurodivergence (e.g., masking, sensory processing, communication) are intertwined with and influence eating, feeding, and body image in neurodivergent people. The session will be interactive, with attendees asked to contribute ideas to the discussion that help to develop skills in asking questions that ‘get beneath’ behaviours to examine underlying sensory, emotional and psychological needs.
35 minute activity - Putting it into practice. Attendees will have the opportunity to engage in a small group discussion using a common clinical dilemma regarding an ED behaviour with an underlying sensory/emotional/communication focus. Attendees will then have the opportunity to role-play how they might engage in this information seeking process and be supported through a process of reflective practice.
10 minute - Wrap up and next steps. Attendees will be given the opportunity to reflect on learning, consider how they will implement new skills within their work and begin devising an action plan. Attendees will receive a copy of the report and practical lift-outs to support implementation of the knowledge and skills learned within the workshop.
Workshop attendees will:
1. develop an understanding of the range of unique factors affecting neurodivergent people's experiences of eating disorders and the implications for provision of mental health care and their own practice;
2. return to their work in the mental health field with enhanced knowledge and skills for the provision of neurodiversity-affirming care.