The longer I’ve worked in mental health, the less convinced I’ve become that people’s experiences fit neatly into single stories. I’ve found myself mentally revisiting people I’ve worked with in the past, regarding whether their neurodivergence was lost beneath latter ‘layers’ as mine was. The hallmarks obscured by lifetimes of resilience and resourceful overcompensation, plastered over vulnerabilities and different ways of coping.
I’ve seen that the convergence of trauma, mental health struggles, and neurodivergence when they intersect can itself become an additional layer that can interact with everything else, beyond what diagnostic criteria may accurately or fully capture or identify.
The chicken or egg dilemma regarding whether struggles are either trauma, neurodivergence (or something else), can be sometimes be productive. Other times it can be reductive because of course it can be both, (or even several experiences concurrently or over time).
Layers of hardwired (innate or neurodevelopmental) differences and softwired (learned or acquired) struggles, traumas, ways of surviving and the toll these all take in an increasingly difficult world, are what can comprise and contribute to mental health struggles.
Ways of coping and surviving can be established, perfected, adapted, over or under-used, suppressed or abandoned at different stages of life, then found again, and re-adapted to current situations.
Some such layers, or their combination may attract various labels and diagnoses that could fit all at once, or at different points in a person’s life.
The purpose of diagnostic frameworks is to guide understanding and treatment and they can be very helpful in doing so. However I also sometimes see some as overly focused on traits or symptoms that are observable ‘outside’ a person, and considered in isolation from function, life context and the nuance of life experiences.
I’ve seen that such limitations with diagnostic frameworks may result in someone gaining multiple labels in a lifetime – attempts to capture and explain everything not explained by one. I wonder if this can sometimes result in confusion and stigma for the person on the receiving-end, who may consequently then end up with another label, self or clinically imposed: ‘complex’. This can unfairly suggest both for the client and the clinician a bleak clinical outlook.
If I’ve learned anything as a mental health professional and as a human being, it is that we are all multidimensional, with different temperaments, wiring, life experiences, personalities, and ways of adapting, so arguably all complex in one way or other.
Sometimes I wonder whether, by attempting to clearly define one experience, there is a risk of unhelpfully allowing one dominant story to overshadow everything else in an unhelpful way.
Other times I hope and have seen that pinning something down – whether diagnostically, personally or therapeutically, and giving meaning to an experience is often helpful to be able to begin to navigate it, especially when it is considered one chapter or even a paragraph of a larger story.
And of course, whatever narratives or frameworks are congruent and helpful for someone to truly make sense of and navigate an experience or their identity are completely valid.
© 2026 Lorraine Welch. All rights reserved
Related further reading
acuriousroute 