This is the first article in a six-part series introducing the SOFT™ Wellbeing Framework — a neurodivergent-affirming alternative to the NHS 5 Steps to Mental Wellbeing, built for people who process experience through cognitive empathy rather than affective empathy.

The guidance that's supposed to be for everyone

If you've looked up mental health support on the NHS website, you'll have found the 5 Steps to Mental Wellbeing. They are:

1. Connect with other people

2. Be physically active

3. Learn new skills

4. Give to others

5. Pay attention to the present moment (mindfulness)

They're presented as universal. Evidence-based. Applicable to everyone. And to be fair, for a lot of people, they work. If your brain processes experience through feeling — through emotional connection, embodied awareness, and social bonding — then connecting, moving, learning, giving, and being mindful are reasonable, helpful suggestions.

But they don't work for everyone. And for a significant portion of neurodivergent people, they don't just fail — they can cause active harm.

I know this because I am one of those people. I'm a former mental health nurse, a qualified aromatherapist, and someone who has been through cancer treatment while neurodivergent. I also lack affective empathy and function on cognitive empathy. That doesn't mean I don't understand emotions — I understand them precisely, sometimes more precisely than people who process emotions. It means I access that understanding through cognition: through logic, pattern, structure, and reasoning, not through feeling.

The NHS 5 Steps were not built for my operating system. And I'm not alone.

The thing nobody talks about: empathic disequilibrium

Before I break down why each step fails, you need to understand why it fails. It's not a preference thing. It's not stubbornness or "not trying hard enough". It's a different cognitive architecture.

In 2022, researchers at the University of Cambridge, led by Dr Varun Warrier, identified something called empathic disequilibrium — an imbalance between two types of empathy:

• Cognitive empathy is the ability to understand what someone else is feeling (or what you are going through) through reasoning, pattern recognition, and logical inference.

• Affective empathy is the ability to actually feel — to share — another person's emotional state or to access your own emotions through embodied experience.

Most people have a rough balance between the two. But many neurodivergent people have a significant imbalance — high cognitive empathy with lower affective empathy, or vice versa. This isn't a deficit. Warrier's research found that empathic disequilibrium is predictive of autism diagnosis and autistic traits beyond general empathy measures. It's a different way of processing the world.

I'm the first profile: high cognitive empathy, low affective empathy. I understand situations with precision. I can tell you exactly what's happening, what it means, and what needs to happen next. But I don't access that understanding through feeling. I access it through thinking.

Here's why that matters for the 5 steps: every single one assumes affective empathy as the primary processing route. Each step asks you to do something that works best when you process through feeling. When you don't, the step doesn't just underperform — it asks you to use a processing pathway that isn't your primary one, which is exhausting, and in some cases, harmful.

Let me walk through them.

1. Connect with other people

The NHS says, "Good relationships are important for your mental wellbeing. They can help you build a sense of belonging and self-worth, give you an opportunity to share positive experiences, and provide emotional support."

Here's what actually happens for many neurodivergent people: social interaction requires masking — the effort of manually performing social behaviours that come naturally to neurotypical people. Eye contact, small talk, reading social cues, matching emotional tone. Research by the National Autistic Society and multiple academic studies shows that high levels of masking are associated with negative mental health outcomes, authenticity challenges, and burnout.

Then there's the double empathy problem, identified by Damian Milton in 2012. Communication breakdowns between autistic and non-autistic people are not one-directional — they're mutual. The neurotypical person fails to read the autistic person just as much as the other way around. "Connect with other people" assumes that connection is straightforward and restorative. For many ND people, it's costly and depleting — you spend more energy than you get back.

During cancer treatment, this becomes acute. People want to support you, and they express it through emotional language: "You're so brave." "It's okay to cry." "Let it out." For someone on cognitive empathy, these aren't comforting—they're prescriptions for an emotional performance you may not be able to give. Connection during crisis isn't simple. It's a second job.

2. Be physically active

The NHS says: "Being active is not only great for your physical health and fitness. Evidence also shows it can also improve your mental well-being."

I'm not going to argue that movement doesn't help. It does. But "be physically active" as a well-being step assumes access to physical spaces that, for many neurodivergent people, are sensory nightmares.

Gyms are loud, bright, crowded, and smelly. Swimming pools echo. Exercise classes have music and instruction you have to process in real time. For someone with sensory processing differences, these environments don't reduce stress — they trigger flooding, which is the nervous system's response to sensory overload.

Then there are physical barriers: dyspraxia (which affects coordination), proprioceptive differences (awareness of where your body is in space), and executive function challenges that make the logistics of exercise – planning, packing, travelling, remembering – a multi-stage project that consumes the very cognitive bandwidth the exercise was supposed to replenish.

During cancer treatment, "be active" becomes almost cruel. Your body is being subjected to chemotherapy, radiation, and surgery. The suggestion to exercise — however well-meaning — can feel like the system hasn't noticed what's actually happening to you.

3. Learn new skills

The NHS says, "Research shows that learning new skills can also improve your mental wellbeing by boosting self-confidence and raising self-esteem and helping you to build a sense of purpose."

This step assumes cognitive capacity is available. During trauma — a cancer diagnosis, ongoing treatment, or chronic stress — cognitive bandwidth is already maxed out. Your brain is running at capacity just processing the medical information, the decisions, the logistics, and the appointments. Adding "learn a new skill" is adding one more thing to an overloaded system. It's the opposite of wellbeing.

For some neurodivergent profiles, there's also demand avoidance — a genuine neurological response where imposed demands (even enjoyable ones) trigger a threat response. "You should learn something new" is a demand. The brain reads it as pressure, not opportunity.

And here's the irony: many neurodivergent people are already perpetual learners. We deep-dive into special interests with an intensity and focus that most people never experience. The problem isn't that we don't learn — it's that the kind of learning the NHS suggests (a casual class, a new hobby, or something social and structured) doesn't match how we learn, and during crisis, there's no room for it anyway.

4. Give to others

The NHS says: "Research suggests that acts of giving and kindness can help improve your mental wellbeing by creating positive feelings and a sense of reward, giving you a feeling of purpose and self-worth."

This step assumes emotional surplus — that you have emotional bandwidth to draw from and give away. For someone processing through cognitive empathy, giving is cognitive labour. You're not drawing from an emotional well; you're working out what's needed, deploying the right response, and managing the social dynamics of the interaction. That's work, not replenishment.

During cancer treatment, this step is particularly damaging. You're already depleted — physically, cognitively, and often socially. Being told to "give to others" when you can barely get through the day adds guilt to exhaustion. And if you're masking – performing warmth and care you don't feel because the situation demands it – giving becomes another performance, another layer of the mask.

There's also an unexamined assumption here: that giving is inherently restorative. For many neurodivergent people, especially those with high cognitive empathy, we understand what others need and we give precisely and effectively. But the giving is analytical, not emotional, and it costs us energy rather than restoring it. The NHS framework doesn't account for that — it assumes the emotional reward of giving is universal. It isn't.

5. Pay attention to the present moment (mindfulness)

The NHS says, "Reminding yourself to take notice of your thoughts, feelings, body and the world around you is the first step to mindfulness. Paying more attention to the present moment can improve your mental wellbeing."

This is the step that can cause the most direct harm, and it's the one I want to be most careful about because mindfulness is prescribed almost universally now – in NHS wellbeing guidance, in counselling, in cancer support services, and in workplace wellness programmes.

Here's the problem: the most common forms of mindfulness — the body scan, the eyes-closed, still-body, "notice what you feel" approach — rely on interoception: the ability to read your body's internal signals. For a significant proportion of neurodivergent people, interoception doesn't work the way the mindfulness script assumes.

Research shows that up to 50% of autistic people experience alexithymia — difficulty identifying and describing emotions. 'Interoceptive confusion' means the body scan at the heart of most mindfulness practice can amplify distress rather than reduce it. You're told to "notice what you feel" — but what if the signal isn't arriving in a readable form? What if "noticing" means becoming suddenly, overwhelmingly aware of sensory input you were managing fine when you weren't paying attention to it?

For some neurodivergent people, eyes-closed, still-body mindfulness causes sensory flooding — a sudden, overwhelming influx of sensory data that the brain was filtering out. It can trigger anxiety, dissociation, or trauma responses. During cancer treatment, when the body is already a site of distress and discomfort, being told to "tune into your body" can be actively re-traumatising.

Mindfulness isn't universally harmful — research shows it can work for neurodivergent people when adapted: movement-based, music-based, sensory grounding, or using special interests as a mindful focus. But the standard, unadapted version that the NHS recommends? For many of us, it's the most dangerous step on the list.

So what's the alternative?

I'm not writing this to tear down the NHS framework without offering something in its place. The 5 steps may work well for people whose operating system is affective empathy. The problem is presenting them as universal – as if one size fits all, when neurology tells us it doesn't.

I've spent the last few years developing an alternative. It's called the SOFT™ Wellbeing Framework, and it's built for a different operating system: cognitive empathy. It doesn't ask you to feel your way to wellbeing. It asks you to frame your way there – through structure, logic, mapping, and cognitive meaning-making.

The framework has four steps:

• S — Stabilise: Regulate your nervous system before any cognitive or emotional work begins. Sensory environment management comes first — always.

• O — Orient: Map the situation cognitively. Build the model before you enter it. Understanding is the beginning of processing.

• F — Frame: Construct a cognitive framework that gives the experience structure and meaning — through logic, not feeling. This is processing, not avoidance of it.

• T — Transition: Move forward with a structured, adapted plan — not through emotional resolution, but through functional progression.

The substitution of "Feel" with "Frame" is the whole thesis. You don't have to feel your way to well-being when you process through thinking. You can frame your way there – and that's not a lesser path. It's a different one.

I developed this framework because I needed it myself — during cancer treatment, during recovery, and in the everyday experience of navigating a world built for a different operating system. It's grounded in peer-reviewed research on empathy, neurodivergence, and neurodiversity-affirming care. And it's built on lived experience — my own, and the many neurodivergent people I've worked with as a former mental health nurse and an aromatherapist specialising in sensory-safe products.

Over the next five articles, I'll show you how it works — in theory and in practice. I'll walk you through real medical experiences during cancer treatment — including my own — where each SOFT step was missing, what happened as a result, and what would have changed. I'll give you practical tools you can use right now, whether you're a patient, a carer, or a practitioner.

Because the current system delivers information and support reactively — during or after the event — and then asks you how you feel about it. The SOFT Framework says the cognitive map must exist before the experience begins. The stabilisation tools must be in place before the nervous system is challenged. And the framing must be built before the situation demands it.

That's not a small adjustment. It's a different sequence entirely. And for those of us who process through thinking, it's the difference between being asked to operate in a language that isn't ours and having a framework that speaks it.

This is Article 1 of 6 in the SOFT™ Wellbeing Framework series. Article 2: You Don't Have to Feel Your Way to Wellbeing — Introducing the SOFT™ Framework →

The SOFT™ Wellbeing Framework was developed by Annette Friar, Burnt Orchid Organics. Sensory-safe aromatherapy, made for neurodivergent minds. Explore the full framework →

References:

• Warrier, V. et al. (2022). Empathy quotient, empathic disequilibrium, and autism. Nature Communications. PMC9804307

• Milton, D. (2012). On the ontological status of autism: The double empathy problem. Disability & Society.

• Kinnaird, E. et al. (2019). Alexithymia and autism spectrum disorder. PMC9839896

• NHS UK. 5 steps to mental wellbeing. nhs.uk

• National Autistic Society. Masking. autism.org.uk

• Cage, E. et al. (2024). How can we make therapy better for autistic adults? PMC12089669