When Words Don’t Cooperate: Navigating Verbal Communication Struggles as a Neurodivergent Psychologist

Written by: Jasmine K. Y. Loo (Psychologist)

Verbal communication is a central part of my work as a psychologist. I spend my days listening, responding, guiding conversations, and helping clients make sense of their thoughts and emotions. But as an AuDHD psychologist, I have always struggled with verbal expression in ways that are often invisible to others — until they aren’t.

For many neurodivergent people, communication is not just about knowing what to say; it’s about translating internal thoughts into spoken words in real time, managing social expectations, and navigating how our words are received. Someone once kindly told me that I’ve got a way with words after they read my book, and I thought, “Well, yeah, when I’ve got 500 hours to mull over them”. When verbal communication falters, it can create frustration, insecurity, and at times, self-doubt — especially in a profession where clarity and precision are highly valued.

When My Words Don’t Match My Thoughts

One of the biggest challenges I experience is word transposition and verbal fumbles. My brain may be thinking one thing, but my mouth sometimes delivers something entirely different. I might mean to say one word and replace it with another without realising. And sometimes, the word I need is just... gone. I find myself having to describe a simple word because I can't retrieve it — “the thing that you sit on in class” instead of “chair”, for example. 

Other times, I may pause mid-sentence, aware that something I just said didn’t come out quite right but unable to pinpoint why. That, or I simply cannot remember what the next half of my sentence was going to be. It's frustrating, especially in a profession where words are my primary tool. This can be especially so when I am tired, overwhelmed, or under pressure. 

The effort it takes to self-monitor while speaking — checking if my words match my intent while still staying present in conversation — can be exhausting. These challenges with verbal communication can become even more pronounced when I conduct sessions in Mandarin, Cantonese or Hokkien, despite them being my first languages. Since all my professional training was completed in English, it can be even more taxing on my executive function (and hence my verbal communication demands) to conduct sessions in non-English languages. 

In my personal life, these moments may be met with patience or humour, but in my professional role, where precise communication matters, my neurodivergent verbal communication struggles can spark a deep sense of frustration with myself.

Finding the Balance Between Directness and Softness

Another challenge I face is modulating how direct or indirect I should be in my communication. Naturally, I tend to be straightforward and concise, but I’ve learned over time that this can come across as blunt or insensitive. In an effort to soften my communication, I often find myself embellishing my words — adding qualifiers, extra explanations, and social niceties to make sure my message is received as intended.

But the irony is that this can sometimes have the opposite effect. Instead of making my communication more palatable, it can make it feel long-winded, vague, or even confusing. Trying to walk the line between being clear but not too abrupt, concise but not too sharp, is something I constantly work on (even this sentence itself sounds exhausting already). The reality is, there is no universal “right way” to communicate — only the best fit for each context.

The Weight of Performance Anxiety

Because verbal communication is so integral to my work, I sometimes feel an added layer of pressure — a fear that my moments of verbal disfluency could impact how I am perceived as a professional. Will a client interpret a momentary speech fumble as uncertainty? Will a misplaced word disrupt the rapport I’ve built? These thoughts aren’t constant, but they do appear, particularly when I’m speaking in higher-stakes situations, such as presentations or professional discussions.

I know that communication isn’t just about words — it’s about the connection, intent, and meaning behind them. But in a field where communication is the main tool of our work, the occasional disconnect between what I intend to say and what actually comes out can sometimes feel frustratingly out of my control.

What's Helped With My Neurodivergent Verbal Communication Struggles

Over time, I’ve developed some ways to navigate these communication challenges in a way that supports my work:

• Pausing before responding – Allowing myself a few extra seconds to process before I speak can reduce the likelihood of verbal fumbles. This also includes sitting with the discomfort from the possibility of others being aware of my slower rate of speech.

• Checking in with clients – I regularly check in with clients (a shout-out to the one university tutorial we had on active listening strategies) to make sure we’re still on the same page. If I notice a moment of miscommunication, I clarify rather than letting self-doubt take over. Simple questions like, “Does that make sense?” or “Let me rephrase that another way” help bridge any gaps.

• Leaning into written communication – Sometimes, written explanations supplement verbal ones, especially for complex topics. Using visual aids or follow-up summaries can reinforce key points. I find that most of my neurodivergent clients appreciate this approach, too, which is also why I ended up making so many infographics.

• Accepting imperfection – I remind myself that fluency does not always equate to effectiveness. A momentary fumble doesn’t negate the knowledge and support I provide.

Final Thoughts

I know I’m not alone in this. Many neurodivergent professionals experience communication struggles that are invisible to others, yet deeply felt internally. The more we talk about these experiences, the more we normalise the reality that communication is not always effortless, even for those in professions that rely heavily on it.

At the end of the day, I’d like to think that the message we’re trying to deliver matters more than how perfectly we say it. And for me, the most important part of my work is not delivering flawless sentences — it’s fostering a space where clients feel heard, safe, and understood.

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