The Story Underneath

Teaching consent isn’t just about reading an age-appropriate book about asking permission for a hug.

It’s about how we live with children.

It shows up in thousands of ordinary moments: how we touch them, how we listen, what happens when they say no, how we handle our own boundaries, and whether they learn that other people’s boundaries matter too.

Consent is less a lesson than a way of being in relationship.

If setting boundaries makes you feel guilty, anxious, selfish, or like you’ve just committed a minor felony by saying “No, I can’t do that,” you are not alone.

For many neurodivergent adults—especially people with late-diagnosed ADHD, late-diagnosed autism, or a lifetime of trying to fit into a world that wasn’t designed for their nervous system—people pleasing wasn’t just about being nice. It may have been a survival strategy.

When you’ve spent years paying close attention to what everyone else needs, expects, wants, or might possibly be upset about, you can become remarkably good at reading other people and remarkably disconnected from yourself.

And there’s the problem:

You can’t really know your boundaries until you know what you need.

It started with what seemed like a fairly mundane administrative request.

I have never participated directly with insurance companies. I built my private practice outside of insurance from the beginning. My clients pay me directly for their care, and some choose to use their out-of-network benefits and submit documentation to their insurance company for possible reimbursement.

Until recently, that meant I didn't need to be credentialed with an insurance company. I didn't need a CAQH account. I wasn't part of an insurance network.

Then Blue Cross Blue Shield asked me to register as an out-of-network provider.

Wait.

What?