Episode 13
Divergent Mind
Jenara Nerenberg, 2020
What ties autism, ADHD and sensitivity together?
Juno and Beck are synthetic voices. They are not people, they are not clinicians, and nothing in this episode is about you. The script was drafted with AI assistance and edited and approved by Logan Williamson, a Licensed Professional Counselor in Texas and Louisiana.
Chapters
At the eyepiece
What the episode covers
Jenara Nerenberg, a journalist with degrees from the Harvard School of Public Health and UC Berkeley, published Divergent Mind with HarperOne in 2020. Its argument comes in three steps: the research that defined autism and ADHD was done mostly on boys; girls are taught early to blend in, so their traits go quiet and get filed as anxiety or low mood; and heightened sensitivity, to sound, light, texture and other people's moods, is the thread that ties a family of conditions together. She builds one roof over autism, ADHD, sensory processing disorder, synesthesia and the highly sensitive person, Elaine Aron's temperament, and gives the back third of the book to well-being, home and work. Its best story is her own: after years reporting from Asia she came home to California, recognized her own traits at thirty-two by reading rather than assessment, and found that the calm neighbor she used to see on morning walks was Dr. Nick Walker, an autistic scholar of the neurodiversity paradigm, living a few blocks away.
Beck checks three claims and takes his time with each. Girls are missed in autism counts held: in a 2017 meta-analysis of 54 prevalence studies, studies that screened whole populations found about three boys for every girl, fewer than studies that counted existing diagnoses, and the authors called it a diagnostic gender bias. Sensory differences in adult ADHD held as a strong lead: in a Dutch clinic group of 116 adults, sensory over- and under-sensitivity tracked ADHD symptoms rather than autistic traits, and about four in ten of the women reported it. The book's figure that at least a fifth of people are neurodivergent could not be traced to a study that counted it; autism and ADHD in adults fall well short on their own, and a 2018 study co-authored by Aron found about three in ten adults in the most sensitive group, on a trait spread across everyone.
The roof over all five stays open: some readers say folding a common temperament in with a disability blurs the disability, and the book's answer is that sensitivity is the shared experience. Juno defends the roof as a reader's way in; Beck calls it a reading list, not a verdict, and connects it to the show's running disagreement about VAST. Both note the women in the book are mostly educated professionals. The AI beat uses a chat window to draft the request the book's last chapters are about, and leaves the asking with the reader.
The scoreboard
What the book claimed,
and what held
One row for every claim the show checked on air, with the verdict in the show's own words and the method that produced each number. A figure from a registry and a figure from a twin study do not mean the same thing, so neither is printed bare. What each verdict means.
Held
Women and girls are missed.
Loomes and colleagues, 2017. About three boys for every girl in studies that screened whole populations (3.25 to 1), against 4.56 to 1 in studies that counted existing diagnoses.
MethodA meta-analysis of 54 prevalence studies, mostly of children. The authors read the gap as a diagnostic gender bias: girls who meet criteria are less likely to be diagnosed. The adult women the book describes haven't been counted as cleanly.
Source01
Held as a pattern
Sensitivity runs through ADHD, not only autism, and especially in women.
Bijlenga and colleagues, 2017. About four in ten women with ADHD (43 percent) reported sensory over- or under-sensitivity, against 22 percent of men; sensory differences tracked ADHD scores, not autistic traits.
MethodQuestionnaires in one Dutch clinic group of 116 adults, compared against published norms rather than a matched group. A strong lead, not a closed case.
Source02
Still arguing about it
At least a fifth of the population is neurodivergent.
Song and colleagues, 2021; Brugha and colleagues, 2011; Lionetti and colleagues, 2018. Not traced to any study that counted it. Persistent adult ADHD is about 2.6 percent and autism about 1 percent of adults; about 31 percent of adults fell in the most sensitive group on the highly sensitive person scale.
MethodThe figure reads as a sum of several estimates, and whether it reaches a fifth depends on counting high sensitivity, which the research that measures it treats as a continuous temperament.
Still arguing about it
High sensitivity belongs under one roof with autism, ADHD, sensory processing disorder and synesthesia.
Lionetti and colleagues, 2018. No figures; a question of categories.
MethodSome readers say folding a common temperament in with a disability blurs the disability; the book holds that sensitivity is the shared experience and keeps the conditions separate. Studies measure the trait; they don't settle the category. The hosts disagree and leave it open.
Source03
Calibration
Sources
Every research claim on air is listed here with the method behind its numbers. Where a claim on air could not be traced to a source, it is named at the foot of this list rather than quietly left out, and the figure is not repeated on this page.
- About three boys for every girl when everyone is screened.
Loomes R, Hull L, Mandy WPL. What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry. 2017;56(6):466-474. DOI
54 prevalence studies, 13,784,284 participants, mostly children. Pooled male-to-female odds ratio 4.20; 3.25 in studies that screened the general population against 4.56 in studies that counted only existing diagnoses. The authors conclude there is a diagnostic gender bias.
- Sensory differences track ADHD, not autistic traits, especially in women.
Bijlenga D, Tjon-Ka-Jie JYM, Schuijers F, Kooij JJS. Atypical sensory profiles as core features of adult ADHD, irrespective of autistic symptoms. Eur Psychiatry. 2017;43:51-57. DOI
116 adults diagnosed with ADHD at a Dutch adult ADHD clinic completed the Adolescent/Adult Sensory Profile and the Autism-spectrum Quotient, compared against norms. Hyper- and hyposensitivity were related to ADHD score, not autistic symptoms. 43 percent of women and 22 percent of men reported them. Self-report, one clinic, no matched comparison group.
- About three in ten adults in the most sensitive group, on a continuous trait.
Lionetti F, Aron A, Aron EN, Burns GL, Jagiellowicz J, Pluess M. Dandelions, tulips and orchids: evidence for the existence of low-sensitive, medium-sensitive and high-sensitive individuals. Transl Psychiatry. 2018;8(1):24. DOI
906 adults completed the Highly Sensitive Person scale. Latent class analysis found 31 percent high, 40 percent medium and 29 percent low sensitivity; the authors describe environmental sensitivity as a continuous, normally distributed trait. Elaine Aron is a co-author.
- Adult ADHD prevalence.
Song P, Zha M, Yang Q, et al. The prevalence of adult attention-deficit hyperactivity disorder: a global systematic review and meta-analysis. J Glob Health. 2021;11:04009. DOI
Population-based studies of adults. Persistent adult ADHD 2.58 percent; symptomatic adult ADHD 6.76 percent. On the page only, to show what autism and ADHD alone contribute to the book's figure.
- Autism prevalence in adults.
Brugha TS, McManus S, Bankart J, et al. Epidemiology of autism spectrum disorders in adults in the community in England. Arch Gen Psychiatry. 2011;68(5):459-465. DOI
2007 household survey of adults in England; weighted prevalence 9.8 per 1,000, about one in a hundred. Carried from episode 6. On the page only.
- Synesthesia and autism.
Baron-Cohen S, Johnson D, Asher J, et al. Is synaesthesia more common in autism? Mol Autism. 2013;4(1):40. DOI
164 autistic adults and 97 controls, online questionnaire. Synesthesia in 18.9 percent against 7.2 percent; the validation test proved unsuitable for autistic synesthetes. Supports the book's grouping of synesthesia with autism. On the page only, not discussed on air.
The book
Divergent Mind. Jenara Nerenberg, 2020.
This link earns Lone Star Telehealth nothing. The same book is at any bookseller or library, and your library is the cheapest way to find out whether you want it.
Book facts stated on air: title and author; a journalist with a public health degree; 2020; her move home to California after years reporting from Asia; feeling like she wore a mask among other parents at her daughter's preschool; articles in her feed about overlooked women with ADHD and autism; her daughter's remark that she was running in circles; the three-step argument (research done mostly on boys, girls taught to blend in, sensitivity as the common thread); the history chapter's move from hysteria to anxiety; a generation missed because they seemed to be coping; the roof over autism, ADHD, sensory processing disorder, synesthesia and the highly sensitive person; Elaine Aron's temperament; mirror-touch synesthesia; the onion image of the person; a reporter's structure, and chapters on well-being, home and work; the neighbor who turned out to be Nick Walker; finding Steve Silberman's NeuroTribes and noticing it centers boys and men; recognizing her own traits at thirty-two by research rather than formal assessment; her curiosity, copying others and reading alone; a student doubted for being smart and a woman treated for anxiety before autism was recognized; 'temperament rights', coined on a flight from South Korea to Nepal; the figure of at least a fifth of the population; the conditions kept separate under one roof. No passage is quoted.
Every word
Transcript
Every line, with the timestamp beside it. Tap a timestamp and the audio moves there.
Full transcript, 173 lines
Juno: A reporter comes home to California after years of covering Asia.
Beck: Good degrees. Good bylines.
Juno: And she can't keep a schedule. The house is chaos. At her daughter's new preschool, she feels like she's wearing a mask around the other parents.
Beck: Then the articles start showing up in her feed. Women with ADHD. Women with autism. Women nobody had noticed.
Juno: And she reads them like they're about her.
Beck: Divergent Mind. Jenara Nerenberg, a journalist with a public health degree. Her case is that a lot of neurodivergent women got filed under anxious, and that sensitivity is the thread that ties them together.
Juno: Her toddler had already reviewed her, by the way. Told her she was just running in circles.
Beck: Tough room. And no footnotes.
Juno: Kinder than some of the reviews, though.
Beck: We'll get to those. Fair warning, this is a journalist's book, not a researcher's. So the science check works a little differently today.
Juno: Today: Divergent Mind, Jenara Nerenberg, 2020.
Juno: Lone Star Telehealth brings you The Observatory.
Juno: Last time Solden came back with Michelle Frank, and the subtitle told readers to embrace neurodiversity.
Beck: Today a journalist takes that word past ADHD. Into autism, into the senses, and into a lot of women who found it late.
Juno: So what's she arguing? In a sentence.
Beck: It comes in steps. Step one, the research that defined autism and ADHD was done mostly on boys.
Juno: And then wrote the checklists from what they saw.
Beck: Yeah. From what they saw. Step two, girls get taught early to blend in. So the traits go quiet, and what shows up instead looks like worry, or low mood, or a woman who's a bit much.
Juno: Hysterical, a century ago.
Beck: That's her history chapter. The label changes with the decade. The habit of labeling stays.
Juno: So who's she writing for?
Beck: Women who look fine from the outside and aren't fine inside. She describes a whole generation of them, missed because they seemed to be coping.
Juno: Coping, from across the room.
Juno: And step three?
Beck: Sensitivity. A nervous system that takes in more. Sound, light, texture, other people's moods. She thinks that's the common thread.
Juno: Common to what, though?
Beck: She builds one roof over several things. Autism. ADHD. Sensory processing disorder. Synesthesia.
Beck: And the highly sensitive person, a temperament the psychologist Elaine Aron described in the nineties.
Juno: One of those is not a diagnosis.
Beck: No. Hold that thought. It's where I'll spend the most time.
Juno: Synesthesia I know a little. Days of the week with colors.
Beck: That's the familiar kind. She also describes mirror-touch, where seeing someone get hurt registers in your own body.
Juno: That sounds like a lot to carry through a day.
Beck: Her point is that it's one more input most people never have to manage.
Juno: There's an image she uses that stuck with me. A person as an onion.
Beck: Go on.
Juno: Genes, biology, childhood, and then the senses, a layer most of us never get asked about. Her complaint is that the usual help works on the outer layers and skips that one.
Beck: That's the move that makes the book hers. Plenty of people wrote about women and ADHD before her. She puts the senses at the center.
Juno: And the writing?
Beck: Like a reporter working a story she's inside. Her own life, then women she interviewed, then the research, laid in between.
Juno: And the back half?
Beck: Practical. Chapters on well-being, on home, on work. How to set up a room, how to ask for what you need, how a workplace could plan for minds like these from the start.
Juno: Let me tell one from the book.
Beck: The neighbor.
Juno: Yeah. The neighbor. Before all this, someone walks down her street every morning with a young daughter.
Juno: And she notices, because this person looks completely at ease. Unhurried. Glad to be outside.
Beck: Rarer than it should be, on a weekday morning.
Juno: Months later she's in Asia, reading about neurodiversity for the first time, and a photo comes up on her screen.
Beck: Not the neighbor.
Juno: Yeah. The neighbor. Nick Walker. An autistic scholar, one of the people who built the neurodiversity paradigm. Living a few blocks from her.
Beck: So the idea she was looking for walked past her house every morning.
Juno: And she had no name for it yet.
Beck: Dr. Walker also teaches aikido in Berkeley. Which might explain the calm.
Juno: Fair.
Juno: From there the internet does what it does. It hands her Steve Silberman.
Beck: NeuroTribes. Our episode six.
Juno: And she notices something about it. Most of the autistic people in it are boys and men.
Beck: That's fair to Silberman. He wrote a history, and the early clinical history was mostly written about boys.
Juno: So she goes looking for the women. And what she keeps finding is sensitivity.
Beck: Tell me about her own part. That's the piece the rest hangs on.
Juno: She recognized her own traits at thirty-two. By reading. Articles, research, interviews with women who sounded like her.
Beck: Not by assessment.
Juno: No. She says it in the introduction. She chose research over a formal diagnosis.
Beck: Keep that in your pocket. We'll come back to it.
Beck: What did the hiding look like, for her?
Juno: Curiosity, mostly. She asked questions all the time. Good for a reporter, not so good for making friends.
Juno: So she copied the people around her, kept the questions to herself, and spent more time alone with books.
Beck: So the questions went underground.
Juno: Until the articles. One was by a college student who said nobody believed she struggled, because she was so clearly smart.
Juno: Another was about a woman treated for severe anxiety, until someone recognized she was autistic.
Beck: Smart, so she must be fine. Anxious, so that must be all it is.
Juno: Those two mistakes run through the whole book.
Juno: One more small moment. On a flight from South Korea to Nepal, she comes up with a phrase. Temperament rights.
Beck: Meaning what?
Juno: That the way a person's nervous system runs deserves the same respect as the rest of who they are.
Beck: That's the book's argument in two words.
Juno: And the second half is her trying to make room for it.
Juno: Okay, your assessment. And you said this one works differently.
Beck: It does. A journalist's book makes claims in passing, without the study beside them. So I picked the ones the book can't stand without, and I checked those.
Juno: Start with the first chapter. Women get missed.
Beck: For autism there's a good test of that. A 2017 meta-analysis pooled prevalence studies. Millions of people, mostly children.
Juno: Okay.
Beck: Some of those studies counted only people who already had a diagnosis. Others screened everyone, diagnosis or not.
Juno: And the two kinds don't agree.
Beck: They don't. Count the diagnoses and you get the familiar picture. Far more boys.
Juno: And screen everybody?
Beck: The gap narrows. About three boys for every girl.
Juno: So some of the girls were there all along. Just not on paper.
Beck: That's how the authors read it. They called it a diagnostic gender bias. Girls who meet the criteria are less likely to be given the diagnosis.
Juno: That's her first chapter in one finding.
Beck: Close to it. One limit. These were mostly children. The women in her book are the grown-up version of that gap, and nobody's counted them as cleanly.
Juno: Next one. I'd always filed sensory trouble under autism. She puts it in ADHD too.
Beck: A Dutch team checked that in 2017. They gave a sensory questionnaire to a clinic group of adults diagnosed with ADHD.
Juno: Compared against what?
Beck: Published norms. And they measured autistic traits at the same time.
Juno: Why those?
Beck: Because autism and ADHD often come together. They wanted to know whether the sensory part was just autism showing through.
Juno: Was it?
Beck: No. The sensory differences tracked the ADHD symptoms, not the autistic traits. More ADHD, more sensory trouble.
Juno: And the women?
Beck: About four in ten of the women reported being over or under sensitive. Noticeably more than the men.
Juno: That's not a side note.
Beck: Yeah. Not a side note. The authors called sensory differences a key feature of adult ADHD, especially in women.
Juno: So that's a point for her.
Beck: A point, with a caution. Self-report, one clinic, and norms instead of a matched comparison group. A strong lead. Not a closed case.
Juno: Now the roof. The thing you told me to hold.
Beck: A number first, then a category. The book says neurodivergent people make up at least a fifth of the population.
Juno: I feel like I've seen that one on a poster.
Beck: It gets repeated a lot. I couldn't trace it to any study that counted it. It reads like a sum of several estimates.
Juno: So the sum depends on what goes in.
Beck: Right. Autism and ADHD in adults, going by the population studies, don't come close on their own.
Juno: And high sensitivity does.
Beck: Yeah. High sensitivity does. A 2018 study gave the highly sensitive person scale to hundreds of adults.
Beck: About three in ten landed in the most sensitive group.
Juno: That's a lot of people to call divergent.
Beck: It is. And here's the part that matters for the book. The same study found sensitivity spread across everyone, low to high, the way most traits are.
Juno: So the groups are just places on a line.
Beck: Cut points on a line. Not a separate kind of person. And Elaine Aron is one of that paper's authors.
Juno: So by the measure's own makers, it's a temperament.
Beck: A temperament. Which brings us to the category.
Juno: She puts it under the same roof as autism and ADHD.
Beck: And that's where a lot of readers push back. Some say a trait that common, folded in with a disability, blurs the disability.
Juno: And her side?
Beck: That sensitivity is the shared experience, and the label matters less than what the nervous system goes through. She keeps them as separate conditions. The thread is what they share.
Juno: This is VAST again. Turned around.
Beck: Say more.
Juno: Hallowell wanted a trait name in place of a diagnosis. She wants a trait name standing next to the diagnoses.
Beck: And I didn't like it the first time.
Juno: I still do.
Beck: Then it's an open entry. It's a question about categories, and studies don't settle categories. People argue them.
Juno: The thing in my pocket. She found her traits by reading.
Beck: And she says so herself. Some readers hold that against the book. Others answer that a book about women the system missed is going to come from some of them.
Juno: And you?
Beck: I score claims, not credentials. The claims we checked mostly stood up.
Juno: Now, for this one. Who does it reach, and who does it miss?
Beck: You start. You're carrying it.
Juno: It reaches the woman who's spent years being called anxious and never asked why the office lights bothered her so much.
Juno: It hands her words before she has a diagnosis, or if she never gets one. That's a book you can pass along.
Beck: I'll grant that. Here's who it misses. The women in it are mostly professionals. Degrees, careers, jobs where you can ask for a quieter desk.
Juno: Readers said that too. Mostly white, mostly comfortable.
Beck: A lot of neurodivergent women don't have that desk to ask for. The advice still points somewhere useful. It just assumes some room to move.
Juno: And some readers felt it went light on the hard parts.
Beck: It's hopeful on purpose, and that's a fair choice. It just isn't the whole picture for someone in a hard stretch.
Juno: Can I defend the roof, though?
Beck: Go ahead.
Juno: For a reader, the roof is the gift. A woman who never fit any single checklist finds herself in the overlap. That's where she's been living.
Beck: As a place to start reading, I'll give you that. It's a reading list, not a verdict.
Juno: And one thing it leaves for later. It keeps saying mask, and never takes the mask apart.
Beck: Which is why it sits right before Price on Logan's list. She shows the hiding. He takes it apart.
Juno: Before we close. The last part of the book is about rooms and requests. How you set up a home, and what you ask for at work.
Beck: And asking is where people stall. The words come out wrong, or they don't come out.
Juno: That's a spot where a chat window might help.
Beck: It might. Describe your week to it. Where you were drained, where you weren't. Ask it to sort that into what helps and what costs you.
Juno: Then turn that into a request.
Beck: A rough first draft of one. You rewrite it in your own voice. It's a scaffold for your own life, and nobody's tested it as anything more.
Juno: And what doesn't go in?
Beck: Health history, diagnoses, anything you'd want kept private. A chat log isn't a medical record, and nothing obliges anyone to guard it like one.
Juno: So it helps with the wording. The asking stays with you.
Beck: Which is her point. Temperament rights don't mean much until somebody says what they need, out loud, to the person who can change the room.
Juno: Divergent Mind, Jenara Nerenberg, 2020. Read it for the women who found the word late, and for the neighbor on the morning walk. Read the high sensitivity chapters as an argument about categories.
Beck: My count. Girls missed in the autism counts, held. Sensory differences in adult ADHD, held as a strong lead. The fifth of the population, not traced, and it leans on a temperament.
Beck: And the roof over all of it stays open. Eleven books in, that's the first open entry that's a category and not a finding.
Juno: I'd keep it close for someone in the first months after the word lands.
Beck: With the cut points paper beside it.
Juno: Beside it. Not inside it.
Beck: Next time: Unmasking Autism, Devon Price. Nerenberg showed us who got missed. Price names how it happens. Masking, and what it takes out of a person.
Juno: She kept saying mask. I want to see the machinery.
Juno: Beck.
Beck: Juno.
Juno: Two days.
Juno: The Observatory comes to you from Lone Star Telehealth. Logan Williamson is a Licensed Professional Counselor in Texas and Louisiana. This was education about a book, not counseling, not a clinical opinion about you, and not a stand-in for care. A diagnosis takes a real conversation with a real clinician, so nobody got one here.
Beck: Every source and the full transcript are on the episode page. The next one is two days out.
Juno: Before you go, a plain note. Juno and Beck are synthetic voices. We're not people, we're not licensed, and nothing here was about you. The script was drafted with AI help, then edited and approved by Logan Williamson at Lone Star Telehealth. Logan Williamson is a Licensed Professional Counselor in Texas and Louisiana.
Corrections
No corrections have been made to this episode. If we got something wrong, write to [email protected] and say where in the episode it was. We check the claim against the source, then we fix it or we explain why it stands. Either way you get an answer.
Questions about the book
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Logan Williamson is a Licensed Professional Counselor in Texas and Louisiana. The Observatory is education about books. It is not counseling, not a clinical opinion about any listener, and not a substitute for care.
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