From shame and self-doubt to leadership and systems change.
By Lara McLachlan, October 26 2026
It started with a lunch-and-learn that never happened. Actually, two of them.
In two different healthcare organizations, I tried to advance conversations about neurodiversity. I had studied how to improve healthcare and organizational systems, and I wanted to put that knowledge to work. I had read more than 100 articles and a dozen books that season, and participated in support groups where so much of what I was learning resonated with my own experiences.
I wanted to talk at work about neuroinclusive patient care, accessible employment practices, accommodation systems, peer support, and the changes we could make to help people participate and succeed as employees.
At times, the conversations were more expansive about what I could do. But what was on offer in the end was going to be one lunch-and-learn. Less than an hour to talk about these issues, one time.
In both organizations, as I tried to move the conversation beyond awareness toward meaningful change, even those sessions were cancelled. I have thought about that since.
Not because the cancellation of a lunch-and-learn was itself such a terrible loss, but because it reflected something much larger: the expectation that I should fit inside a box someone else had decided was appropriate, when I knew it would not be effective for the actual goal.
What I experienced was not simply frustration, or annoyance at not getting my way. It was shame. Shame at being my authentic self, genuinely trying to make a meaningful contribution, and having that rejected. This is a particular risk in lived experience-led work, where the knowledge, perspective, and personal investment someone brings can be inseparable from the way they contribute.
This is where the story of NCF begins.
The shame of not fitting
For many neurodivergent people, shame accumulates over a lifetime through these kinds of experiences. We genuinely try. We show up authentically. We invest enormous effort and energy in communicating well, explaining ourselves, and contributing meaningfully. And still, it often generally just goes wrong. We are told, directly or indirectly, that the way we think, communicate, work, respond, or relate to others is wrong. We may be restricted, mocked, excluded, dismissed, or punished for it.
We are misunderstood, corrected, or treated as difficult when we are trying to contribute. Our intentions are questioned, our capabilities underestimated, and our differences interpreted as personal deficiencies. After all, they are characterized and named as disorders. Over time, we can begin to see ourselves through the eyes of the people and institutions that view us this way.
Being challenged is important. We all need that. But when it is shame that emerges, I believe it has gone further than disagreement or constructive criticism. We begin to question our actual judgment. We doubt our abilities. We stop trusting what we know and feel. We wonder whether we really are asking for too much, or just in fact are actually and unavoidably too much. And eventually, we can begin imposing on ourselves the very limitations that others have imposed on us. Or worse. That is what makes shame so consequential.
Shame doesn't just shape how we feel about ourselves. It can shape what we believe is possible for our lives, what risks we are willing to take, and whether we feel ready, willing and able to contribute at all. We cannot answer endemic neurodivergent unemployment and underemployment without asking these questions and looking at these issues.
From shame to systems
There is a growing body of academic literature examining what happens when neurodivergent people are repeatedly expected to change themselves to fit environments that were not designed to include them. Research on autistic masking (Hull et al., 2017) and minority stress (Botha & Frost, 2020) demonstrates how social pressures, repeated invalidation, and stigma can affect people's identities, mental health, well-being, and relationships with themselves.
Hennekam and Follmer (2026), drawing on interviews with neurodivergent workers, found that stigma, combined with the double empathy problem—mutual misunderstanding between neurodivergent and neurotypical people—can lead employees to camouflage their differences at work. This can undermine well-being and reduce their confidence in expressing ideas and exercising influence. Organizations, in turn, may overlook their strengths, capabilities, and knowledge by failing to seek out or encourage their contributions.
Cameron (2026) identifies three bases of what she calls neurodistinct stigmatization: label, invalidation, and deviance. Her research shifts attention toward how stigma is produced through organizational norms, social expectations, and the judgments of others, rather than focusing primarily on how neurodivergent people should manage their stigmatized identities. This distinction matters. We cannot understand exclusion only by examining how individuals respond to it. We also need to examine the conditions that create it.
Research also points to what helps. Huang and colleagues (2023) found that greater self-understanding following an autism diagnosis was associated with lower internalized stigma and improved well-being. Their research highlights how people can begin to reinterpret experiences they previously understood as evidence of personal inadequacy.
As I read this literature, I recognize something that is both deeply personal and much larger than my own experience. These findings have important implications for neurodivergent leadership development and the program model NCF is creating.
If people have spent years learning to question themselves, conceal their differences, or limit their contributions to meet other people's expectations, developing leadership capacity involves more than teaching skills, offering self-employment training and loans, or matching people with jobs.
It also involves rebuilding trust in our own knowledge, perspectives, and capabilities. Still, individual self-understanding is only part of the answer. We cannot ask neurodivergent people to overcome internalized shame while leaving intact the organizational cultures, practices, and power structures that perpetuate it.
We need to change both our relationship with ourselves and the systems that shape what we believe is possible. That is the connection between shame and systems change.
In my case, instead I stopped thinking about lunch-and-learn permission, and I began building the work I had wanted to do. I developed a neuro-inclusive healthcare curriculum, secured funding, and established partnerships. My work expanded into developing major grant proposals and partnerships to advance more inclusive accommodation processes in universities and employment systems.
I built research partnerships, studied theory, listened to people's experiences of leadership, and began developing approaches to neurodivergent leadership development grounded in those experiences. All of this became the work of the Neurodiversity Change Foundation. Creating a Board, communicating regularly with the public, making new relationships, putting together grants, and taking real risks.
And in doing this, my relationship with myself changed. To be honest, over time, I felt freer. Less afflicted by the limitations and judgements of others, and more able to trust myself and pursue the work I believed mattered.
Leadership and our relationship with ourselves
Our relationship with ourselves, and the pain we may carry within it, has become central to the neurodivergent leadership development work we are undertaking. Leadership development is often understood in terms of building skills: communication, strategic thinking, decision-making, networking, and confidence. Those things matter. But our relationship with ourselves is vital.
How do you become a leader when you've spent much of your life being told that your judgment is unreliable, your efforts inconsistent, your communication inappropriate, your needs excessive, or your ideas unrealistic?
Or when you are simply left out, overlooked, and not included in conversations at all? How do you exercise authority when you've learned to question whether you deserve to have a voice? How do you begin changing a system when you've spent decades believing that you are the problem? These are questions about identity, power, belonging, and the consequences of repeated experiences of invalidation, not a person's confidence alone.
And they have implications for how we design neurodivergent leadership development programs. We need to understand not only how neurodivergent leadership emerges, but what enables it to develop and be sustained. That includes opportunities to build capabilities and relationships. It includes access to networks, resources, mentorship, and meaningful roles.
But it also includes creating opportunities to rebuild self-trust, recognize the value of our own knowledge and experiences, and develop a sense of agency that may have been undermined over many years, across systems. Leadership development should not require us to become more acceptable versions of ourselves before our contributions are taken seriously. It should help us develop the capacity and opportunity to exercise influence as ourselves and make informed decisions that are safe for ourselves.
Three relationships that need to change
I see three interconnected dimensions of this work.
Our relationship with ourselves: Moving from shame and self-doubt toward self-understanding, self-trust, and agency.
Our relationships with others: Moving from concealment, misunderstanding, and exclusion toward recognition, connection, belonging, and collective power.
Our relationship with systems: Moving from being expected to adapt endlessly toward having the authority, resources, and opportunities to reshape the institutions that affect our lives.
These relationships influence one another. More inclusive institutions can make it easier to trust ourselves. Greater self-trust can help us exercise influence. Collective action can create the conditions for others to participate and lead. And changing whose knowledge is recognized, whose perspectives are included, and who has the authority to shape decisions can transform the institutions themselves.
This is why neurodivergent leadership development must be about more than teaching people to succeed within existing structures, or assuming that an invitation to the table is the same as empowerment. It is also about changing the conditions under which leadership becomes possible. As Kania, Kramer, and Senge (2018) describe in The Water of Systems Change, meaningful systems change involves shifting the policies, practices, resource flows, relationships and connections, power dynamics, and mental models that hold deep entrenched problems in place.
For neurodivergent leadership, this means changing not only who has opportunities to participate, but whose knowledge is valued, who exercises influence, and the assumptions that shape what we believe neurodivergent people can contribute.
Why I put Change in our name
When people ask me why I called our organization the Neurodiversity Change Foundation, this is what I think about.
Change is about how we understand ourselves and how we exercise agency. It is about how institutions and systems recognize and respond to neurodivergent people. And it is about the change we can make together.
In the end, I'm glad those lunch-and-learns never happened. I'm glad all of this happened instead.
Selected research
Botha, M., & Frost, D. M. (2020). Extending the minority stress model to understand mental health problems experienced by the autistic population. Society and Mental Health, 10(1), 20–34. https://doi.org/10.1177/2156869318804297
Cameron, C. R. (2026). Stigmatization of neurodivergence in the workplace. Frontiers in Psychology, 17, 1818600. https://doi.org/10.3389/fpsyg.2026.1818600
Hennekam, S., & Follmer, K. (2026). “Why our voices don't count”: The employment experiences of neurodivergent employees through a double empathy lens. Organization, 33(2), 158–183. https://doi.org/10.1177/13505084241295747
Huang, Y., Trollor, J. N., Foley, K.-R., & Arnold, S. R. C. (2023). “I've spent my whole life striving to be normal”: Internalized stigma and perceived impact of diagnosis in autistic adults. Autism in Adulthood, 5(4), 423–436. https://doi.org/10.1089/aut.2022.0066
Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M.-C., & Mandy, W. (2017). “Putting on my best normal”: Social camouflaging in adults with autism spectrum conditions. Journal of Autism and Developmental Disorders, 47(8), 2519–2534. https://doi.org/10.1007/s10803-017-3166-5
Kania, J., Kramer, M., & Senge, P. (2018). The water of systems change. FSG. https://www.fsg.org/resource/water_of_systems_change/
