Kirstan Puttick Lloyd Psychologist, Wilmslow (2025)

17/07/2025

Too often, mental health assessments are reduced to a checklist exercise—quick screenings, surface-level diagnoses, and generic treatment recommendations. While this may be enough for straightforward presentations, I believe we have a professional responsibility to do better for clients whose experiences are complex.

When we accept superficial assessments, we risk reinforcing misdiagnosis, ineffective treatment cycles, and system-driven burnout. Clients deserve more than labels—they deserve to understand themselves in a way that informs meaningful, tailored care.

This is why I advocate for specialist psychological assessments that are depth-oriented, collaborative, and formulation-led. It’s about recognising the interplay of neurodivergence, trauma, personality structure, and life context—not just symptom management.

At the heart of it, thorough assessment isn’t a luxury—it’s a fairness issue. Accurate understanding should be the starting point of any therapeutic journey, especially when people are already navigating fragmented healthcare pathways.

For those of us working in mental health, offering depth-informed assessments is not just good clinical practice—it’s a commitment to equity, dignity, and better outcomes.

Let’s stop doing more of the same and start offering more of what actually makes a difference.

10/07/2025

What if neurodivergent burnout isn’t a reflection of individual fragility — but a warning about the world we’ve built?

Workplace accommodations are so often framed as concessions. As if rest, clarity, autonomy, or sensory safety are indulgences — reserved for those who can’t keep up. But that framing rests on a dangerous assumption: that the default environment is reasonable to begin with.

What if it isn’t?

What if modern work was never truly designed for anyone — let alone those with sensory sensitivities, cognitive differences, or a limited tolerance for performance and pretence?

When neurodivergent people burn out, it may not be because they are weak — but because they are unwilling or unable to sustain what others silently endure. Like the canary in the coal mine, their collapse may signal not personal failure, but environmental toxicity.

We pathologise their distress instead of asking what it reveals.

And yet, the very things we call accommodations — structure, rest, flexibility, transparency — may not be special allowances at all. They may simply be the conditions required for sustainable human functioning.

So perhaps the question is not: “What do neurodivergent people need that others don’t?”

But rather: “What if their needs reveal what all of us need — and what too few of us receive?”

23/06/2025

🧠 CBT is often considered the gold standard in therapy.
It’s evidence-based, structured, short-term, and works well for targeted issues like phobias or habits.

But what about clients whose struggles are less clear-cut?

As Nancy McWilliams reminds us—not all suffering is a problem to be “solved.” Many people (especially those with trauma, neurodivergence, or deep emotional struggles) don’t show up with neat, textbook symptoms.

Often, it’s not that therapy has failed…
It’s that the model wasn’t built for their complexity.

A biopsychosocial approach explores:

• Biology (temperament, sensory profile, neurodivergence)
• Psychology (attachment, trauma, internal defences)
• Social factors (family roles, gender scripts, culture)

This way, therapy moves beyond surface-level fixes.
It becomes a collaborative process of meaning-making, regulation, and identity growth.

📌 Especially for complex cases, we need more than a protocol.
We need frameworks that hold the whole person.

✨ Curious to hear your thoughts:
When has structured therapy helped—or fallen short—in your experience?

06/06/2025

Should therapy include goals for real-world connection?

We know relationships shape the brain, regulate emotion and help build identity.

But do we treat them as core to psychotherapy, or as secondary outcomes?

Clients often retreat from the world to feel safe. But if that safety comes at the cost of isolation, growth stalls.

In this piece, I ask a difficult but timely question: Should psychotherapists promote real-world relationships as a cornerstone of treatment?

It’s not about prescribing connection. It’s about helping clients move through fear, develop relational skills, and re-enter the world with more flexibility and resilience.

Therapy is not just a sanctuary. It’s also a rehearsal space for being with others, tolerating difference, and choosing connection over avoidance.

04/06/2025

How do we strengthen relationships?

It’s a question that matters in every part of life — in families, friendships, teams, and therapy rooms.

Emotional safety doesn’t just appear. It is built through consistent, everyday habits that create trust, repair tension, and allow us to stay connected even when things feel hard.

Here are a few of those habits I’ve seen make the biggest difference:

- Be curious, not critical

- Speak with clarity and kindness

- Listen to understand, not to fix or blame

- Repair after rupture

- Create safety in small moments

- Grow through challenge

These are not quick fixes. Instead, they are ways of relating that take time, reflection, and practice.

But they change things, helping relationships become places where we can show up fully and authentically.

https://www.helixcentre.co.uk/post/why-we-need-relationships-the-link-between-connection-emotion-and-the-social-brain

02/06/2025

Why do we form relationships?

It’s a question I often ask in therapy.

And while the answer seems obvious, it’s not always easy to put into words.

From infancy, human connection shapes the brain. It teaches us how to regulate emotion, build identity and find a sense of safety in the world.

But for some people, connection feels hard, even painful.

However, the pain of disconnection is not just emotional, it registers in the brain like physical pain, reminding us that we are wired to need each other.

Whether shaped by trauma, neurodivergence, or personality structure, the result is often the same: a longing for closeness mixed with fear of it.

This visual post is my attempt to distil a complex idea into a simple thread:
We need others to survive, not just physically, but emotionally.

What helps you feel safe and seen in your relationships?

27/05/2025

Mind the Gap: The Space Between the Experience and Expression of Self

We all mask. But for some, the cost is higher.

Masking is not inherently pathological. It can be seen as the social process of managing our expression to fit expectations or norms. We hold back, perform, and adapt in order to facilitate social cohesion.

In neurotypical adults, this can feel relatively effortless as it is often supported by stable executive functioning and a well-integrated sense of self.

But in neurodivergent individuals, especially those with ADHD, autism, BPD, or trauma histories, masking becomes survival-driven.

What’s Happening Beneath the Surface?
-Executive functions (EFs) regulate how we manage emotion, attention, and behaviour
- When underdeveloped, the gap between internal reality and outward behaviour widens
- Chronic masking leads to a “false self” — polished outside, disconnected inside

Why It Matters
- Relationships can become strained
- True intimacy can be blocked by self-protection
- The body holds the cost — fatigue, shutdowns, shame
- Identity suffers — masking becomes a lifestyle, not a choice

Rebuilding the Connection
- Understand EF as neurodevelopmental, not moral
- Strengthen interoception and body awareness
- Seek relational safety — therapy, community, co-regulation
- Use structure to reduce self-presentation effort
- Explore the role of the false self in your history

This post explores the neurobiology, development, and psychological cost of the gap between who we are and what we show.

Read the full article: https://lnkd.in/d6FmUD8a

24/05/2025

Recently, someone asked a powerful question:

“What are the ways to work around missing quality relational safety?”

There isn’t a simple answer, but it’s one of the most important challenges we face in today’s modern world, especially in the context of rising mental health struggles among young people.

We are social creatures living in systems that increasingly fail to meet our neurobiological needs. As Jonathan Haidt, Lenore Skenazy, and others have pointed out, we are raising a generation of children in digital spaces, often indoors, online, and overstimulated, without the developmental ingredients that foster relational safety: unstructured play, face-to-face repair, and tolerable risk.

Many evidence-based psychological treatments also assume a foundation of social engagement. There is an expectation that clients practice vulnerability, trust, and co-regulation in the real world.

But what happens when those opportunities are rare, or even unsafe?

From a biopsychosocial perspective, this absence has far-reaching effects:

- Biologically, we’re wired for co-regulation, not isolation. Without safe relationships, stress systems remain chronically activated.
- Psychologically, early relational gaps can lead to internal working models that expect rejection, inconsistency, or performance.
- Socially, we now navigate relationships through curated screens and unrealistic expectations (I couldn’t help thinking of influencer culture and hyper-performance).

So what can we do? We need dual focus:

- Externally: advocacy for systemic change (in education, policy, family, and culture) to create environments where relational safety can be experienced.
- Internally: recognising, reprocessing, and relearning what safe connection feels like.

Relational safety is the bedrock of emotional regulation, self-development, and healing. We can’t overlook it; but we can start to rebuild it, from the inside out and the outside in.

Let’s keep this conversation going. It matters.

hashtag hashtag hashtag hashtag hashtag

22/05/2025

Executive Function in Neurodiverse Adults: What Went Wrong and How to Rebuild It

Many adults live with executive functioning difficulties, not because they are disorganised, lazy, or emotionally reactive, but because their brains never had the scaffolding they needed early on.

What Is Executive Function (EF)
· EF is the brain’s internal management system: planning, focus, memory, flexibility, and regulation
· It develops through early-life co-regulation and predictable structure
· It is not about motivation — it is about wiring

What Went Wrong (Developmental Gaps)
· Trauma or chaos in early life can disrupt EF development
· Neurodivergent brains often need more structure than most environments provide
· Many EF delays are missed because intelligence or coping masks the underlying struggle

How It Shows Up in Adult Life
· “I know what to do, I just can’t do it”
· Emotional blowups or freeze responses when overwhelmed
· Shame, confusion, or avoidance after repeated setbacks

Work, Relationships, and Parenting
· Missed deadlines, disorganisation, or overworking at jobs
· Conflict or withdrawal in relationships due to reactivity
· Overstimulation and guilt in parenting — with no internal buffer

Misdiagnosis and Shame
· Many are told they are “lazy” or “too sensitive”
· Undiagnosed ADHD, autism, or trauma are often mislabelled as failure
· Repeated invalidation creates deeply embedded shame cycles

What Can Help (Real-Life Supports)
· Use visual planners, timers, and whiteboards
· Build micro-routines and predictable transitions
· Pair structure with emotional regulation: sensory breaks, co-regulation, and embodied self-awareness

You are not disorganised, you are under-supported.

Executive function can be rebuilt… not through willpower, but through structure, relational safety, and self-compassion.

https://www.helixcentre.co.uk/post/executive-function-in-neurodiverse-adults

21/05/2025

Clients often come to therapy with the expectation that they will feel better, and quickly. In a culture that promotes quick fixes and instant results, it’s understandable that people expect therapy to offer immediate relief.

In many ways, this is a fair assumption when we offer mental health services. There is an implicit understanding that we will identify difficulties, set treatment goals and help the person feel better.

However, in many cases, clients need containment before the depth work can start.

In my experience, especially with individuals navigating neurodivergence, trauma, or emotional dysregulation, the real beginning of therapy is not skills development, self-regulation strategies, insight or depth work — it’s stabilisation.

It helps clients regulate overwhelming emotions, reduce dissociation, and create internal and external safety. Through routine, co-regulation, and relational repair, stabilisation prepares the nervous system to tolerate distress and reflect on experience, ultimately making deeper trauma processing possible.

Without this foundation, therapy risks becoming retraumatising instead of healing.

Phase-based models for complex mental health challenges highlight that stabilisation shapes the treatment, offering the foundation for successful treatment.

Too often, this phase is skipped or minimised. But in truth, it’s what allows deeper work to become possible.

15/05/2025

Most of us are running on empty.
Tired but wired. Distracted but overwhelmed.
Trying to regulate in environments that weren’t built for humans.

Nature changes that.
It doesn’t just calm your thoughts. It calms your whole system.
Your breath slows. Your shoulders drop. Focus returns.
You feel a little more like yourself.

You don’t need a retreat. You just need a few quiet minutes outside.
That’s enough to begin.

Nature is not a luxury. It is a biological need.

Kirstan Puttick Lloyd Psychologist

17/07/2025

10/07/2025

23/06/2025

06/06/2025

04/06/2025

02/06/2025

27/05/2025

24/05/2025

22/05/2025

21/05/2025

15/05/2025

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