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A gilded cage is still a cage

'Clinical' is a word that is part of the framework and the furniture of my job as a Speech and Language Therapist (SLT). It trips off the tongue of colleagues without question and populates documents, policies and procedures. Yet, I wonder, in all its commonplace and everyday presence, do people ever really stand back to think about what that word actually implies? Here are two definitions from the Cambridge English Online Dictionary clinical  adjective   used to refer to medical work or teaching that relates to the examination and treatment of ill people expressing no emotion or feelings; showing no character and warmt h In reading these definitions I feel like I want to scream loudly and break free from those words, that box that contains my working life. For all the talk of  care, closeness and individual support  by my professional body, the term  clinical  remains a gilded cage. A cage because these are the words and meanings that frame my day-to-...

My Fuel Bubble

 

After years of traumatic experiences for my Autistic teen at physical schools, mainstream and specialist, and for us as a family, we have all greatly benefited from access to education from home. Recently, he teen tried to put into words why this was important for him and shared the idea of his ‘fuel bubble’.

He explained that his fuel bubble has several components. It is the physical space, around his desk, as well as the desk itself, set up just the way he likes it. People coming into his space, especially without warning or preparation, use up his available fuel. Even familiar people coming within a certain distance can have this effect. The closer to the desk, the more fuel is used up. Meanwhile the items he chooses to have close, and the way his desk is organised, his way, gives him energy.

When inside his fuel bubble he often connects to others’ fuel bubbles. This can be through virtual connections online, even YouTube videos, but also through real life interaction. Chatting and gaming with friends is important. Equally important is sitting with his guinea pigs alongside. There are times when he can link with multiple fuel bubbles all at the same time. The energy of other bubbles can kick start, sustain or grow the energy he needs for an activity that requires the greatest amount of his attention and focus. This helps explain why ‘body doubling’ is such a useful tool for him. I wonder if it is something like the transfer of kinetic energy, the energy an object possesses by virtue of its movement. The other fuel bubbles are moving, dynamic spaces that themselves create momentum and energy. This energy is then transferred to him, helping him to move and keep focused.

His passions, gaming and 3D computer graphics, are also energy-givers and further important elements of his fuel bubble. Lately, he has also become aware of when these activities can use up available energy. This can happen both through prolonged engagement, and through deep exploration and discovery. His fuel bubble can literally ‘run dry’ because of what he is doing within it. We often talk about ‘listening to our body’ and to the internal physical (interoceptive) signs he notices when energy levels are becoming low. We discuss how to plan to keep energy levels going and what this looks like. This may even mean taking a break from his bubble and looking for different forms of energy, such as having something to eat. 

He also describes certain activities, or separate bubbles, within his own fuel bubble as being like ‘blackholes’; once hooked, there is no escape. YouTube videos are a good example. These can cause a slow, insidious shift and drain of energy from one activity to another. The carefully woven balance of energy inputs and outputs is again destabilised. The overall outcome in this case can be one of inertia.

Managing energy levels in his fuel bubble can be affected by external factors too. There are times, when the energy required to maintain the multiple and dynamic elements of his fuel bubble exceeds the energy that is available from within, and he describes this as his bubble ‘bursting’. An example is when he is interrupted, often when the balance of energy is already close to being ‘maxed out’. This might be due to an unexpected message on Discord, someone coming into his physical fuel bubble space at the wrong moment, or him being asked to come away from his fuel bubble with little warning. Having to hide, mask or camouflage his authentic self is a further energy drain. We have seen this during online meetings with professionals he doesn’t know well or is not sure about. 

When sustaining energy within his fuel bubble reaches a critical level of ‘imbalance’, either through internal or external factors, what we may also see on the outside are meltdowns and shutdowns. These may appear to come out of nowhere, but we are learning to consider all the layers and levels of energy management that lie underneath. We also now recognise that in the past the repeated ‘bursting’ of his fuel bubble, and variable understanding and support for him to build, grow and sustain it, across multiple environments, also contributed to burnout. 

The metaphor of his fuel bubble helps provide a space in which we can all explore and learn about these ideas. We know so much more about what can do to restore his energy, and the time this may take. We can better support him, and he can better advocate for what he needs too. Having the safety and structure of his physical fuel bubble also provides a familiar and reassuring space that he knows he can return to when he needs to. This has been, and continues to be, important for recovery and wellbeing.

This got me thinking about how we all benefit from nurturing our own fuel bubbles; spaces where we can rest and restore energy levels, be our authentic selves, and learn about and advocate for our individual needs and preferences. These are unique and dynamic spaces, as different for each of us, as we are different from each other. For me personally, it is quiet, often low-lit, non-distracting environments, where I can follow my own interests, without restrictions, that fill up my fuel bubble. The multi-stream components of my son’s fuel bubble would cause my own to burst.


Energy, Wellbeing & Neurodiversity

Often a focus on energy in relation to difference and neurodivergence can be around regulation. This is helpful, as it moves away from reliance on feelings and emotions as a framework for wellbeing. For many neurodivergent individuals, feelings and emotions are less reliable concepts and ones that may be difficult to put into words (alexithymia). Furthermore, neurodivergent ways of expressing inner state, bodily feelings and emotions may be poorly understood and even invalidated. 

Reflecting on the idea of ‘fuel bubbles’, I think it is equally helpful to have in mind the idea of ‘energy for thriving’, and how this too supports wellbeing.


Ecosystems and ecology

“An ecosystem is a geographic area where plants, animals, and other organisms, as well as weather and landscapes, work together to form a bubble of life.” (16) The philosopher, Robert Chapman, uses the concept of ecosystem functioning in their ecological model of mental functions, and conceptualises a non-pathological description of what thriving can be. 

“The ecological model has a relational conception of functions and dysfunctions. Instead of locating functioning or malfunctioning inside individuals, (the ecological model) has room to locate it between people (as with the double empathy problem), or in the relationship between people and environment (as the minority stress model shows).” (17)

Understanding our unique and individual fuel bubbles as ecosystems, helps us see how our embodied relationships, connections and environments come together to support us to thrive. Furthermore, we all have fuel bubbles, spaces that we cherish, that nurture and restore our energy, regardless of our neurotype. A universal focus on energy therefore helps reframe ‘them and us’ narratives on accommodations, to those of individual human needs. Energy is something we all need to survive and to thrive. A focus on energy unites us. 


Takeaway thoughts

This isn’t an exhaustive list, more thoughts that I have had during the process of thinking about my son’s original idea, and putting this resource together.

What does your fuel bubble look like? Can you describe it?

What are the physical elements of your fuel bubble?

What are the relational elements of your fuel bubble?

How do you know when you are running low on energy in your fuel bubble? What can you do to get more energy?

Are there things about your fuel bubble you’d like to change? How easy is this to do? 

Is your fuel bubble something you can take with you across different environments? Are there elements you can transfer to different spaces and places?

Do others know about your fuel bubble? Is this something you can share? Is this something you would like to share?

What about the fuel bubbles for others in your life? How does it work when yours and their fuel bubbles bump into each other?

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References

1: Katy, E. (2024, July 18). Autistic Special Interests: Our Brain’s In-Built Coping Strategy. Authentically Emily. 

https://www.authenticallyemily.uk/blog/autistic-special-interests-our-brains-in-built-coping-strategy 

“(Special interests) can help us to navigate day to day life, recharge away from an overwhelming world.”


2: Heasman, B., Williams, G., Charura, D., Hamilton, L. G., Milton, D., & Murray, F. (2024). Towards autistic flow theory: A non-pathologising conceptual approach. Journal for the Theory of Social Behaviour, 54(4), 469–497. https://doi.org/10.1111/jtsb.12427

“Far from being problematic, these experiences (becoming fixated or lost in activities of interest) could be the harnessing of flow, whereby autistic people preserve attentional energy from becoming overloaded.” 


3: Chapman, L. (2023, July 7). Special interests. Autism Understood. https://autismunderstood.co.uk/social-stuff/special-interests/ 

“Special interests can also be predictable, reliable and therefore feel safe. You will likely feel calm and relaxed doing your special interest.


4: Wharmby, P. (2025, February 20). Today's thoughts about neurodiversity, from my archive : Things I love about being autistic...1. I spot patterns really easily - I. [Image attached] [Post]. LinkedIn. https://www.linkedin.com/posts/pete-wharmby-58a2131b2_autistic-autism-autistic-activity-7298257347884314625--JUC?utm_source=share&utm_medium=member_desktop&rcm=ACoAABCzMEgBxoz1vfw9QR1LT7qmQlI08YbmoD8. 

“I love my hyperfixations and special interests, and how calming they are, and how much joy I find in them. So much more than just hobbies, they literally make me able to face the day.”


5: Ryan, J., Brown, H. M., Borden, A., Devlin, C., Kedmy, A., Lee, A., Nicholas, D. B., Kingsley, B., & Thompson-Hodgetts, S. (2024). Being able to be myself: Understanding autonomy and autonomy-support from the perspectives of autistic adults with intellectual disabilities. International Journal of Qualitative Methods, 28(12). https://doi.org/10.1177/1609406917733847

“Our participants told us that being autonomous meant being able to be themselves. They told us three main ways to support their autonomy: (1) having choice and control, (2) being able to communicate in their own way, and (3) being in a safe environment.”


6: Richardson, H. (2025, January 27). My functioning is dependent on my special interests. Cooking, my career, exercise and my dog. This means I can cook [Images attached] [Post]. LinkedIn. https://www.linkedin.com/posts/harriet-richardson-0bb733163_functioning-special-interests-and-hyperfixations-activity-7289613176994766848-dP_c?utm_source=share&utm_medium=member_desktop&rcm=ACoAABCzMEgBxoz1vfw9QR1LT7qmQlI08YbmoD8 

“I manage a career mostly because it is my area of interest. Without an interest in what I’m doing, my working life would look completely different. I genuinely believe that without interest, I wouldn’t hold down a job. As a result of ADHD, anything out of my interest feels like dragging myself through mud. I simply can’t pay attention to things that don’t interest me.”


7: Rivera, L. (2021, May 12). The Need For Autistic and NeuroDivergent Authenticity. Lyric Rivera. Neurodivergent Rebel. 

https://neurodivergentrebel.com/2021/05/12/the-need-for-autistic-and-neurodivergent-authenticity/ 

“Because apparently that’s how some people recharge is going out and socializing and doing things, but that’s not recharging or reinvigorating to me. I need to unplug and do things a bit differently....Being someone else is exhausting.”


8: McGreevy, E., Quinn, A., Law, R., Botha, M., Evans, M., Rose, K., Moyse, R., Boyens, T., Matejko, M., & Pavlopoulou, G. (2024). An Experience Sensitive Approach to Care With and for Autistic Children and Young People in Clinical Services. Journal of Humanistic Psychology, 0(0). https://doi.org/10.1177/00221678241232442

“The practitioner seeks to understand experiences and feelings around their challenges and disability, for example, How does this make you feel? Why do you think you couldn’t do that? Do you want support to improve this or find a workaround? The young person is supported to identify what they need to do and what they want to do. The Spoon Theory (Miserandino, 2003) or energy accounting may be a practical support for supporting well-being and understanding and advocating for one’s needs.”


9: EWOR. (2022, May 20). The Sandwich Theory- transitioning from flow state. Ausome Training.

https://ausometraining.com/the-sandwich-theory-transitioning-from-flow-state 

“How do we explain hyper focus and flow to people who don’t experience it like we do? My relationship with the world means that I interpret and understand things in terms of energy...When Autistics hyper focus we tend to “plug into” or fully engage with what we’re doing...It’s better for us to naturally unplug when the task comes to a natural end than someone cutting the lead with a scissors, leaving us in a state where we are neither plugged in or plugged out- the lead is still attached but going nowhere”


10: 8: Pearson, A. (2023, November 18). Beyond Masking and Towards Supporting Autistic Authenticity. Thinking Person’s Guide to Autism. 

https://thinkingautismguide.com/2023/11/beyond-masking-and-towards-supporting-autistic-authenticity.html 

“Unmasking” might involve a long, reflexive and arduous process that relies on developing a keen self-understanding, and feeling empowered to advocate for one’s own needs.


11: NDTI. (2021). “It’s Not Rocket Science”.

https://www.ndti.org.uk/assets/files/Its-Not-Rocket-Science-v.3.pdf 

“The right sensory environment can support improved health and wellbeing. It can support people to self-manage and to have more energy and concentration for different aspects of life.”


12: Chapman, R., & Carel, H. H. (2022). Neurodiversity, epistemic injustice, and the good human life. Journal of Social Philosophy

https://doi.org/10.1111/josp.12456    

“The approach can inform a revised view of the good life and of flourishing, that is person-centered and moves away from the focus on species-typical function. Such approaches indicate the direction we should take in order to develop neurodiversity-sensitive conceptions of the good life.”


13: Mahler, K. (2024, March 28). Interoception and Monotropism: Paying Attention to Autistic & ADHD Experiences. Kelly Mahler. 

https://www.kelly-mahler.com/resources/blog/interoception-and-monotropism-paying-attention-to-autistic-adhd-experiences/ 

“That state of flow can be a really wonderful experience, but it can also come with some interoception disconnect. A person’s bodily needs might not reach a level of noticing if the person is focused on their task or interest. They might come out of their monotropic flow and realize perhaps that they haven’t slept in a long time, or they haven’t nurtured their other bodily needs like eating, or drinking, or toileting or something else.”


14: Mahler, K. (2024, May 27). My 5 Take-Aways about Interoception, Masking & Monotropism. Kelly Mahler. 

https://www.kelly-mahler.com/resources/blog/my-5-take-aways-about-interoception-masking-monotropism/ 

“It’s all about felt safety first and foremost, and helping each human to feel as safe as possible in their bodies and in their worlds. That is key. The other two themes are curiosity and validation. Helping each person to explore their inner self and to have safe people who are validating that inner experience, what they’re learning, what they’re discovering about themselves...when we project this curiosity and we learn something about another person, we have opportunities to hopefully validate each other’s own unique experience.” 


15: Phung, J., Penner, M., Pirlot, C. & Welch, C. (2021). What I Wish You Knew: Insights on Burnout, Inertia, Meltdown, and Shutdown From Autistic Youth. Frontiers in Psychology. 12:741421. https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.741421/full 

“The descriptions from the children and youth in our study support Leadbitter et al. (2021) suggestion that a crucial element of advancing autistic research and clinical practice is to understand autistic experiences as a way of being which is complex and dynamic”


16. National Geographic. (n.d). Article: Ecosystem. National Geographic. https://education.nationalgeographic.org/resource/ecosystem


17: Chapman, R. (2021, February 21). Neurodiversity and the Ecology of Thought Rethinking the foundations of mental disorder. Psychology.

https://www.psychologytoday.com/gb/blog/neurodiverse-age/202102/neurodiversity-and-the-ecology-of-thought 

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