SUDS and Monotropism in Neurodiversity Affirmative Brainspotting
There are a number of aspects of why SUDS (Subjective Units of Distress) can be disruptive to neurodivergent (ND) folks. The one I'm going to focus on here is the difficulty that arises for folks with monotropic cognitive styles. For those who don't know, monotropism is a cognitive style where individuals tend to focus deeply on a single thing (or a small number of things) rather than spreading their attention across many areas. This is in contrast to a polytropic style, where attention is spread across multiple topics, often more easily and with less depth.
So, here's an analogy: imagine for the moment that everyone gets allocated 100 "attention bucks." Someone with a monotropic cognitive style is likely to have all 100 of their "attention bucks" invested in one topic. Someone with a polytropic cognitive style, in contrast, might have 20 topics that each get 5 "attention bucks."
The other part about "attention bucks" is that they carry a certain level of inertia. The more of them that are invested in one area, the harder they are to move. If you have 5 "attention bucks" invested in 20 topics, they're fairly easy to move around—you might easily shift a few bucks from one topic to another. But if you have all 100 "attention bucks" invested in a single topic, shifting them to another area is much harder and requires extra effort and resources.
How does SUDS fit into this?
When you ask someone with a polytropic cognitive style to check their SUDS, they can often reallocate a few "attention bucks" to that question fairly easily, and without disrupting the balance of their focus.
In contrast, when you ask someone with a monotropic cognitive style to check on their SUDS, they have to divest themselves of the experience they are currently immersed in, shift gears to focus on the SUDS question, orient themselves within that new context, and then try to answer it. By that point, the monotropic person may have lost most or all of their connection to the original experience they were accessing or processing. Then, once the monotropic person has answered the SUDS question, they may struggle to re-access that original activation because of the energy expended in shifting their attention, not once but twice.
So, what to do?
Consider a "front-loading" conversation: Before accessing any activation, have a discussion about what the SUDS is and why you’re asking for it. Explore alternative ways of measuring distress that might resonate more with them. For example, would they prefer to use terms like "low," "medium," and "high"? Could colors help represent their feelings? Would it be easier for them to pick a face from a face chart? Any of these are workable alternatives, but it’s crucial to figure this out in advance, before any activation comes online, so you’re not asking them to shift gears into a cognitive space in the middle of experiencing or processing activation.
Try using SUDS (or its alternatives) as a focusing tool instead of as an evaluation tool: Instead of waiting until they’re at the peak of their activation to evaluate their experience, try asking for the SUDS (or another representation) as a way to help them enter their experience more deeply. This may draw them into the processing rather than pulling them out of it.
Another approach to consider is setting aside the SUDS and focusing immediately on the processing, especially if you can tell through your attunement that the person is already deeply engaged with their activation. Could you get this wrong? Yes, it’s possible. But it’s often easier to correct mid-stream than to help someone re-access an activation they’ve lost because of a disruption in their focus.
Remember, in Brainspotting, maintaining a deep connection to your client and to their level of activation is crucial. For those with a monotropic style, a SUDS check can interfere with your connection to the client as well as interfering with their connection to their own activation. Your relational attunement can often provide all the information you need without requiring them to quantify their distress, so trust your connection to guide the process.
By approaching SUDS with flexibility and sensitivity to the client’s cognitive style, you can ensure that the therapeutic process remains as seamless and effective as possible.
