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Adulting with Autism

April Ratchford MS OT/L
Adulting with Autism
Latest episode

335 episodes

  • Adulting with Autism

    Why Self-Help Doesn't Stick (And What Actually Changes Your Brain) | Josh Davis on NLP

    22/07/2026 | 44 mins.
    Why does so much self-help sound good… and then disappear when life gets hard?
    In this episode of Adulting with Autism, I talk with Josh Davis, PhDβ€”neuroscientist, former Barnard College professor, and NLP (Neurolinguistic Programming) trainerβ€”about practical tools for real change in messy, everyday life. Josh has spent decades teaching neuroscience and psychology, and now focuses on bringing NLP tools to parents, especially dads, who want to show up differently for their kids without getting lost in guilt and overwhelm.
    We dig into why the brain clings to old habits, what "manage attention, not time" looks like for distractible and executive-function-challenged brains, and why joining someone's reality (instead of trying to fix them) can dissolve conflict in seconds.This episode is perfect for neurodivergent adults, parents, and anyone tired of advice that doesn't stick.
    In This Episode, We Cover
    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> What NLP (Neurolinguistic Programming) actually isβ€”and what makes it different from typical self-help

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> How outcome-oriented therapies and NLP grew out of psychotherapy's most effective tools

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Why wanting change isn't enough if different "parts" of you disagree (internal conflict)

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> "Manage attention, not time" as a realistic frame for overloaded, ADHD-style brains

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Why you will never "catch up" on your to-do list, and why that's freeing, not hopeless

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Practical prioritization when your brain can only hold a few important things at once

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Real examples of using NLP with kidsβ€”joining their energy and positive intentions instead of lecturing

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> How separating facts from interpretations helps with triggers (chapter "Just the Facts" in his book)

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Why dads often lack support networks, and how these tools can help them feel less alone

    About the Guest
    Josh Davis, PhD, is a teacher, author, and trainer of Neurolinguistic Programming (NLP). He has taught high school, college, and adults, completed a doctorate in psychology and neuroscience, and served as a professor at Barnard College, part of Columbia University. His work focuses on making powerful change tools from psychotherapy and NLP accessible to everyday people, especially parents and fathers.
    His recent book translates complex NLP methods into simple, usable tools and has become a USA Today bestseller.
  • Adulting with Autism

    Burnout Is a System Failure, Not a Personal Flaw | Human Cognitive Infrastructure with Michael Eskenasy

    20/07/2026 | 25 mins.
    What if burnout isn't a personal failureβ€”but a system failure?
    In this episode of Adulting with Autism, I talk with technologist Michael Eskenasy, creator of Human Cognitive Infrastructure, about why our current app-driven, fragmented world pushes humans to be the "integration layer" for everythingβ€”and how that crushes executive function, especially for neurodivergent people.
    We explore what happens when technology forgets context and intent, why adding more tools often increases cognitive load, and what a "breathable life" could look like if infrastructure actually protected human capacity.
    This one is especially for listeners who feel like they're bad at adulting, constantly overwhelmed by apps, or stuck in burnout despite "optimizing" themselves.
    In This Episode, We Cover
    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> What Human Cognitive Infrastructure is (and why context/intent matter)

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Burnout as a continuity failure, not a personal weakness

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> How fragmented systems and open loops strain executive functioning

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Why "more tools" can make neurodivergent life harder, not easier

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> The coordination layer: incentives, politics, and why systems don't get fixed

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Designing tech that remembers context for you instead of demanding more from you

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Governance, trust, and safeguarding data when tech knows your life

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> What a "breathable life" looks like after burnout and structural exhaustion

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> How clinicians, educators, and employers can think about infrastructure in support plans

    About the Guest
    Michael Eskenasy is the creator of Human Cognitive Infrastructure, a technology concept designed to let systems carry context and intent instead of forcing humans to do all the integration themselves. His work looks at burnout, executive function, and coordination through the lens of incentives, governance, and trust, with a special relevance for neurodivergent households and support environments.
    Find Michael on X (formerly Twitter): @ITSChefreyOS
  • Adulting with Autism

    Why Neurodivergent Couples Struggle to Communicate (And How to Fix It) | Lisa Rabinowitz

    18/07/2026 | 42 mins.
    Why do so many neurodivergent couples say, "We love each otherβ€”but we can't communicate"?
    In this episode of Adulting with Autism, I sit down with couples therapist Lisa Rabinowitz, who specializes in ADHD and neurodiverse relationships, to break down why communication breaks downβ€”and what actually works.
    We talk about the real-life patterns showing up in relationships: constant arguments over small things, interrupting, time blindness, emotional overwhelm, and the exhausting "parent vs partner" dynamic.
    Lisa shares practical, shame-free strategies to help couples understand each other, regulate emotions, and rebuild connectionβ€”even if it feels like things are too far gone.
    If you've ever felt misunderstood in a relationshipβ€”or like you're trying your best but it's still not workingβ€”this episode is for you.
    What We Cover
    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Why couples fight over "small" things (and why they're not actually small)

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> ADHD symptoms in relationships: impulsivity, time blindness, forgetfulness

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> The truth about interrupting (it's not disrespect)

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> How neurodivergent vs neurotypical communication differs

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Emotional regulation and nervous system awareness

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Attachment styles and how past wounds replay in relationships

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Breaking the "parent/child" dynamic

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> What to do if your partner won't go to therapy

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Why "trying harder" doesn't fix relationship issues

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> How real repair and change actually happens

    About the Guest
    Lisa Rabinowitz is a couples therapist specializing in neurodiverse relationships. She is trained in both the Gottman Method and PACT (Psychobiological Approach to Couples Therapy) and works with couples internationally to improve communication, emotional regulation, and connection.
    Website: counselorforcouples.com
    Book: Why Won't You Stop Interrupting Me? Simple Solutions for ADHD Couples (Audiobook coming soon)
    Key Takeaways
    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Love alone isn't enoughβ€”couples need skills and systems

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Many "conflicts" are actually misunderstandings of neurodivergence

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Interrupting is often about processing, not disrespect

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Systems (alarms, notes, structure) reduce relationship stress

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> You don't fix relationships by trying harderβ€”you fix them by doing things differently

    Call to Action
    If this episode resonated with you, share it with someone who needs it and leave a review to help more people find the show.
  • Adulting with Autism

    Missed ADHD, Masking & Burnout: Neurodiversity-Affirming Therapy with Psychotherapist Robert Rackley

    15/07/2026 | 42 mins.
    What if years of "anxiety and laziness" were really undiagnosed ADHD and autismβ€”and therapy kept missing it?
    In this episode of Adulting with Autism, Auntie April MS, OT/L talks with Robert Rackley, an Irish psychotherapist who practices in a sensory-based, neurodivergent-only clinic and specializes in autism and ADHD in adults. Robert first trained in traditional psychotherapy, then shifted his entire practice toward neurodivergence after realizing how often adults are missed or misdiagnosed, especially when they show up with jobs, houses, and families that don't fit stereotypical images of ADHD or autism.
    Robert shares insights from his master's research on why adult ADHD goes unnoticed: masking, narrow stereotypes (e.g., "you can't have ADHD if you're successful"), and professionals who stop at anxiety or depression rather than looking deeper. He explains how labels like "lazy," "disorganized," or "dramatic" are often nervous-system freeze responses to chronic overwhelm, trauma, and catastrophizingβ€”not character flawsβ€”and why so many neurodivergent adults internalize those words for decades.
    The conversation dives into common misdiagnoses (anxiety disorders, depression, personality labels) and how inattentive ADHDβ€”especially in womenβ€”gets misread as "just anxiety." Robert talks about masking as a lifelong survival strategy that starts in childhood ("sit still, stop that") and leads to traumatized nervous systems, identity confusion, and severe mental health consequences, including self-harm and suicidality. He also explains rejection sensitive dysphoria (RSD) in everyday language: the brain searching for criticism, misreading tone and facial cues, and feeling one offhand comment as physical pain that lingers for years.
    From autistic burnout and sensory processing differences to relationships, communication breakdowns, and alexithymia (having no words for emotions), Robert offers a clear picture of what neurodiversity-affirming therapy can look likeβ€”and how neurodivergent adults can safely try therapy again.
    If you're an autistic/ADHD adult who's been told you're "lazy," "too sensitive," or "too much," or you've left therapy feeling blamed and unseen, this episode will help you see your nervous system, your emotions, and your story in a different light.
    In this episode, you'll learn:
    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Why adult ADHD and autism are so often missed or misdiagnosed as anxiety or depression

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> How "lazy" and "disorganized" are often freeze responses and chronic overwhelm, not moral failures

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> What masking does to a nervous system over decades, and why it leads to burnout and identity confusion

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> How rejection sensitive dysphoria (RSD) feels and why one comment can hurt for years

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Practical ways to respond differently to perceived criticism and reduce mind-reading spirals

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> What makes neurodivergent burnout different from typical stress or depression

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Early warning signs of burnout (withdrawal, irritability, food changes, constant overwhelm)

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> What neurodiversity-affirming therapy can look like: sensory rooms, stimming, visual tools, and no pressure to "sit still"

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> How alexithymia ("no words for emotion") complicates talk therapyβ€”and what to do instead

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Questions to ask potential therapists to check if they really understand ADHD and autism

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Common autistic stereotypes ("you can't be autistic if you make eye contact") and how they harm adults

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Relationship patterns between neurodivergent and non-neurodivergent partners, especially around change and predictability

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Concrete self-regulation strategies (fidgets, sensory resets, noise management) and rebuilding self-esteem with kindness

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Gentle first steps for adults who suspect they're autistic/ADHD but feel overwhelmed by the search
  • Adulting with Autism

    Hair Pulling, Shame & Nervous System Coping: Living with Trichotillomania with Jessie Hannah

    13/07/2026 | 20 mins.
    What if the "worst thing you do" isn't a moral failureβ€”but a nervous system trying desperately to self-soothe?
    In this episode of Adulting with Autism, Auntie April MS, OT/L talks with Jessie Hannah, the creator of Bare Becoming, who has lived with trichotillomania (a hair-pulling disorder) since she was seven. Jessie describes trichotillomania as a body-focused repetitive behavior (BFRB)β€”an irresistible urge to pull out one's hairβ€”categorized under OCD and anxiety-related disorders in the DSM-5. She shares how years of hidden pulling, wigs, and intense shame finally led to one radical act: shaving her head. That moment felt like "losing 500 pounds" and marked the beginning of sharing her story instead of hiding it.
    Jessie explains how BFRBs like hair pulling, skin picking, and nail biting are often subconscious nervous system patterns, not conscious choices or character flaws. She breaks down the basics of the nervous systemβ€”sensory input, vagus nerve, the brain's responseβ€”and how coping behaviors start as self-soothing and then become completion loops the body wants to finish. She also talks about anxiety, perfectionism, and all-or-nothing thinking (catastrophizing), and why shame and judgment block the curiosity we need to understand and change our behavior.
    Through Bare Becoming on TikTok and YouTube, Jessie invites people to stop asking "What's wrong with me?" and start asking "What is my behavior trying to protect me from?" She shares tracking tools (like calendar logs of pulling episodes), how that data helped her see patterns (including hormonal cycles), and how small acts of self-awareness can slowly rebuild self-trust. Jessie also speaks candidly about showing up publicly with a shaved head, being asked intrusive questions, dating and relationships while hiding wigs, and the relief of finding community and feeling less alone.
    If you live with hair pulling, skin picking, nail biting, or other hidden coping behaviorsβ€”especially as an autistic or ADHD personβ€”this episode offers language, validation, and gentle first steps toward seeing yourself as understandable, not broken.
    In this episode, you'll learn:
    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> What trichotillomania and BFRBs are, and how they show up in daily life

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Why coping behaviors are nervous system patterns, not moral failures

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> How anxiety, perfectionism, and completion loops interact with pulling and picking

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> The difference between automatic, unconscious behaviors and focused, perfectionistic rituals

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> Why judgment and shame crowd out the curiosity needed for change

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> How tracking episodes (time spent, hairs pulled, triggers) can reveal patterns and progress

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> What Jessie's shaved-head journey has taught her about visibility, questions, and self-acceptance

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> How hidden BFRBs impact relationships and what happens when you finally show up as your full self

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> What's inside her "start here" resource for teens and parents navigating BFRBs

    p]:pt-0 [&>p]:mb-2 [&>p]:my-0"> What it means to become more "understandable to yourself" and set yourself up for success
More Education podcasts
About Adulting with Autism
ADULTING WITH AUTISM A movement for neurodivergent adults, created by autistic occupational therapist April Ratchford, OTR/L. Adulting with Autism is a global community for autistic and ADHD adults navigating independence, relationships, college life, careers, emotional regulation, and real-world executive-function challenges. With over 2.7 million downloads, April blends lived experience, clinical insight, and honest conversation to guide neurodivergent adults into their next chapter of growth. Each episode brings practical tools, mental-health strategies, autistic storytelling, and real talk about boundaries, burnout, sensory needs, finances, friendships, and the messy parts of becoming an independent adult. Featuring leading experts in autism, mental health, neuroscience, accessibility, and creative industries β€” along with deeply human stories from autistic adults around the world. If you're a late-diagnosed autistic adult, a college student trying to survive executive-function chaos, or a neurodivergent person trying to build a life that actually fits β€” you are in the right place. πŸŽ™οΈ Hosted by: April Ratchford, OTR/L β€” autistic occupational therapist, autism advocate, author, and executive contributor to Brainz Magazine.
Podcast website

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