This therapist and mom knows a lot about disability and mental health

By Louise Kinross

I’ve followed Meriah Nichols (above left) since 2011. As a child, she was in a car accident which left her with a brain injury. She is also deaf. As an adult she managed an employment program for students with disabilities at the University of California, Berkeley. When her daughter Moxie was born with Down syndrome, she started a blog called 'With a little Moxie.' Moxie is now 13, and lives with her mom and brothers Micah and Mack in Hilo on Hawaii. Micah, 15, has autism and ADHD, which Mack, 11, is being assessed for. Meriah is a therapist who works with clients who are deaf, hard of hearing and deafblind, as well as those who are neurodivergent or have physical disabilities like cerebral palsy. I thought she would be the perfect person to speak with about mental health.

BLOOM: What is a simple way of describing mental health?

Meriah Nichols: Mental health is psychological, emotional and social wellbeing. So, a simple way of describing it would be how someone’s brain or thinking, or their spirit or ways of interacting with others and the world, serves them and allows them to live the life they would like to live.

BLOOM: Did having disabilities yourself, or kids with disabilities, factor into your decision to become a therapist?

Meriah Nichols: Not at all. I’m an ‘accidental therapist.’ I was initially just trying to get my foot in the door with going back to career counselling—like I worked with at UC Berkeley—or with vocational rehabilitation. I was taking a class in counselling psychology and thought what the heck, may as well apply for the program. I was accepted, and then COVID hit, my kids were at home with me, and I thought I may as well just continue. I really didn’t expect to graduate, not because I didn’t intend to become a therapist, but because I couldn’t afford it. But with COVID, extra money came through the school, COVID living money and I got scholarships that enabled me to continue.

After graduating I looked for jobs with career counselling or vocational rehab but that didn’t pan out. I did get independent work through an agency for therapy. And I now work with three separate agencies. Now I’ve found my groove and have been doing it for a while I’m really glad that I stuck with it and really glad it unfolded the way it did.

BLOOM: What kind of therapy do you offer?

Meriah Nichols: I offer Acceptance and Commitment Therapy (ACT), art therapy, neuro-affirming therapy, dialectical behaviour therapy (DBT), career counselling, which includes looking at disability accommodations, mindfulness training, social skills development and person-centred therapy.

BLOOM: What is neuro-affirming therapy?

Meriah Nichols: Right now I’m working with someone who is autistic and has ADHD and we’re doing research to look at his personality type and his neuro framework and look at careers that support the way he thinks and allow him to blossom. We’re looking at what kind of accommodations and supports are really going to work for him.

BLOOM: What kind of therapies are useful for people living with disabilities?

Meriah Nichols: I think all modes are useful with different people in different ways. Therapy can help people to accept a new disability, uncover and transform internalized ableism, work with grief related to disability or the world, and heal trauma. Remember, people with disabilities tend to be the most vulnerable in terms of abuse. Therapy is also really helpful in understanding how to regulate our emotions and navigate uncomfortable situations, which includes asking for and receiving accommodations, or working with boundaries related to disability.

BLOOM: We offer an online ACT group to our parents here. I’ve found ACT is a good fit for working with disability.

Meriah Nichols: I love that therapy more than the others. It’s so helpful in the disability experience because it’s about accepting it and learning to live in the world in an easeful, mindful, present way. It’s about releasing things that are not helpful and not constantly trying to change ourselves. I don’t believe we’re broken. There are ways we can flourish and live life in a way that’s pleasing to us.

Part of it is that we’re told what we’re supposed to want and what we’re supposed to be yearning for or saving for. But for a lot of us, that’s not it. For a lot of us, what might be pleasing in our own lives might be going out and gardening for four hours a day. So creating a life that is pleasing for us and one that works is up to us to determine.

BLOOM: What does your experience with disability bring to your therapy practice?

Meriah Nichols: I love that question. That made me stop and think. Ultimately it gives me a deep sense of connection to other people. It also gives me a wealth of resources. And my perspective, being in the disability community for a long time and experiencing it from just about every angle, it brings a sense of understanding of how simultaneously important and unimportant disability is.

It is important to process the pain and work through trauma, it’s important to learn to navigate the world and create the life you want to live. But I question the importance of clinging to an identity or clinging to systems or concepts that might not serve us very well.

My personal experience with disability lends that credibility that makes it easier for a lot of clients to talk with me about stuff. They know I know.

BLOOM: What role does ableism play in the mental health of disabled children and their parents?

Meriah Nichols: Ableism plays an enormous role. When a child grows up thinking they’re ‘less than’ or unable to do whatever, or that they need to ‘overcome’ their disabilities, when they’re brought up to strive to be different from who they fundamentally are, it wreaks havoc with their psychological, emotional and social development. It can lead to post-traumatic stress disorder, self-harming behaviour and an inability to function.

For non-disabled parents of disabled kids, ableism reaches deep within their own cultural norms. It requires serious unlearning and personal transformation to recognize it and to consciously weed it out. I think of it like racism—which can be insidious and seeping into our mentality largely unnoticed. It takes conscious effort to shift that narrative and emotional landscape.

BLOOM: What do parents of kids with disabilities need to keep in mind when thinking about the mental health of their child?

Meriah Nichols: In thinking about the mental health of our kids, we are really thinking of the world we are creating for them. It touches their school—their school supports and accommodations. It touches their social lives—what types of friends they have and what types of friendships we as parents encourage and support for our kids. It touches our relationships within our families.

How do we emotionally regulate? How do we communicate as a family? How do we support, validate, encourage and believe in each other? How do we regard disability within our families? As something to be overcome, that’s awful? Or as something that for the most part is a natural and normal part of the human experience? Do we talk about disability like it’s something that has value and adds to the diversity and richness of the human experience?

We need to keep in mind the media we consume in the family and our interactions. When you hear something that’s demeaning about disability or a thread or a joke, how do we as parents approach that to promote this sense that disability has value?

All this stuff contributes to our disabled children’s mental health.

BLOOM: How has having children with disabilities impacted your mental health?

Meriah Nichols: It’s been hard in a lot of ways. Like a lot of parents, I’ve cried over those 504 and IEP meetings. I’ve really struggled through application processes to receive support. It’s been really hard to wade through all the deficit-based language and approaches in the U.S. school and medical systems.

Because I’m profoundly deaf and also neurodivergent, it’s been really hard to make sure I can hear and understand what’s going on, and that I keep track of everything I need to. I’ve definitely struggled with my own mental health in it all.

But I have to say too—I don’t mean to get all Pollyanna about it—but at this point in my life, I think that the children we have are the people we need to get to where we want to be.

For example, I’d like to be the type of person who holds space for others, is wise, has boundaries, is compassionate and open-minded. If I follow through with what my kids need and if I unlearn my own internalized ableism and help my kids develop their own sense of disability pride and empowerment, I’ll actually grow into the type of person I’d like to become.

So it’s hard. But it’s also helping me to become who I’d like to be. It’s worth it.

BLOOM: For parents who are struggling with anxiety and/or depression, what are some strategies they could consider that might help?

Meriah Nichols: It depends on the situation, what type of disability the children or parents have, and what supports are available.

In general though, it’s the simple stuff that tends to make the most difference. Get outside. Exercise. Be with nature. Do something fun. Focus on something that makes you laugh or smile. Pay attention to what you’re consuming: your food, media, even your social connections. Ask how well those are serving you. Adjust. And then consciously and consistently apply the small things to your life—the exercise, being outdoors, and so forth.

When I was pregnant with Moxie, I was told she had a zero chance of being born alive because she would have hydrops—fluid in her tissue and organs—in addition to having Down syndrome. When I had Moxie, the only thing she had was Down syndrome. None of the other stuff was there, and she was born very much alive. It really made me deeply question everything. If [medical professionals] could be so wrong about something so big, what else could they be wrong about? I became very critical and questioning about everything.

I picked and chose her therapy. I would be told ‘she needs this and this and this’ and I would say ‘why?’ or ‘that doesn’t make sense.’ We were blessed because we had a physical therapist who supported our non-traditional ways of empowering or strengthening Moxie. She told us ‘That trip where you drove to Mexico and she crawled on the sand dunes? That’s better than anything I can do.’ It really made me think oh, so this is good. I started looking more at the end goal and not so much the path.

Right now the end goal is Moxie being a makeup artist—that's what she wants to do. So what do we need to do to get her there. It’s not listening so much to all the stuff in the middle. I know we feel like we’re not experts, and these people who went to school for a million years are telling us things in a firm tone. But we must be able to turn that down a little bit, and really listen in our hearts and investigate different ways through. And it’s not always about therapy.

BLOOM: How can families bring more joy into their lives?

Meriah Nichols: Right now I have teenagers and a tween. They fight a lot and moan about chores. My thing is how do I promote the family unit? We do game night. I hate games, but I do it because they love it and it’s the one thing that gets them together.

I try to do some type of travel because we all love travel and we’re good at it and everyone comes together.

I promote special meals like smorgasbord night, where they can build their own meals.

I spend one-on-one time with the kids with things they like to do with me. With Moxie we go swimming a lot. Max drums. I take him to his lessons and I used to do drumming too, so it’s a connecting bond. I wait and we come back and we talk about it. We also do a lot of walking together. With Micah it’s talking or walking or Costco shopping one-on-one.

With all of the kids it’s getting out there in nature which is really easy here because we can see the ocean from our house.

Check out blog posts and resources on Meriah’s website. Like this interview? Sign up for our monthly BLOOM e-letter. Visit us at BLOOM Facebook, follow @LouiseKinross on Twitter, or watch our A Family Like Mine video series.