What does Neurodivergent-Affirming Therapy mean? How Current Therapy Approaches for Autistic Adults May Unintentionally Harm
In recent years, a much-needed shift has emerged in the understanding of neurodiversity, moving away from outdated views of "deficit" and embracing the richness of diverse brain types. One powerful perspective within this movement is the "many brains theory"—the idea that there isn’t one "normal" brain but more recent eras have uplifted and valued one in particular (the “neurotypical” brain). Leaning into this perspective, many autistic or otherwise neurodivergent adults are exploring therapy not as a means to “fix” or “change” who they are, but rather to better understand and support their authentic selves. Here at The Wren Centre, we offer neurodivergent-affirming therapy with the specific aims of empowering and uplifting autistic adults.
Why a Neurodivergent Affirming Approach to Therapy is Needed
Therapists are humans - just like any category of clients, we cannot be represented by specific expectations or qualities. We have different training and education, professional and life experience, cultural influences, and skill sets, which means that often - despite best intentions - we make mistakes or don’t realize how we may be unsupportive for a client’s best progress. For neurodivergent clients, here are a few ways a therapist may unintentionally increase feelings of shame and invalidation in autistic clients if they lack an understanding of neurodivergent-affirming practices or autism spectrum disorder (ASD):
Encouraging Masking or Social Camouflage
Masking and social camouflage refer to the learned methods neurodivergent folks use to “fit in” or ease relationships according to neurotypical social mores. For example, forcing eye contact or enduring social gatherings that are actually overwhelming and unpleasant. Therapists unfamiliar with neurodivergent affirming therapy might encourage clients to suppress autistic traits by turning masking habits into goals of therapy - like celebrating increased eye contact or congratulating them on “stretching their capacity” by attending a party. Therapists may reinforce harmful ideas that autistic traits are undesirable and need to be overcome, reinforcing clients’ experience of anxiety and shame.
Misinterpreting Direct Communication as Rudeness or Defiance
Working with a young autistic client, I once spoke in a euphemism to their parent by saying, “Oh, your kid is letting me know that the table is too much for them right now” - referring to their exit from the screen I could now only see the parent on. From offscreen I heard a clear, “the table is fine - it’s YOU I’m done talking with!”. I thought it was delightful - they were clearly expressing that my approach that day was exceeding their capacity. This clear communication is something that many neurotypical clients struggle with precisely because we have a cultural preference for less direct communication styles. (Note: helping neurodivergent and neurotypical clients express their needs without succumbing to internal criticism is a frequent goal of therapy.)
Autistic clients often communicate in a more straightforward style, which can sometimes be misconstrued as blunt or confrontational. Autistic folks have likely been taught and told how to change their approach to better accommodate neurotypical needs - a constant theme of suppressing themselves for others. A therapist who interprets this as rudeness, a sign of anger/distaste rather than statement of fact, or lack of empathy can inadvertently invalidate the client’s communication style, reinforcing a belief that their way of interacting is wrong or unacceptable.
Prioritizing Neurotypical Social Norms
With many of my neurodivergent or neurotypical clients, I do not ask them how they are when they come in. First of all, that’s a pretty loaded question from your therapist. Second, “how are you?” is a communication social norm that doesn’t really mean “how are you?”. Thus, clients may experience increased stress or nervousness navigating the inherent contradiction created by (1) my therapist is asking me how I am and we are here to address deep and complex emotional experiences that are impossible to summarize in a few sentences right alongside (2) my therapist is a person and when people ask you that question you’re supposed to respond in one of a few socially acceptable ways. Whether a client is on the autism spectrum or not, it can be more supportive and efficient to skip small talk and open sessions with more direct questions and guidance.
When therapists uplift the importance of eye contact, small talk, or other neurotypical social expectations, they may overlook the fact that these behaviors are not comfortable or natural for many autistic clients. Forcing these norms can lead to internalized shame, as the client may feel their natural ways of connecting are inferior or inappropriate. All humans, including therapists, can benefit from questioning social norms - why do we think eye contact is superior? (We think this is how you know someone is listening and respecting you.) Hm - you listen with your ears; that’s not totally logical.
Using Pathologizing and Contrasting Language
Even clinicians and authors writing on neurodivergent, autistic or twice-exceptional (2E) topics with the intention of myth-busting and shifting common misperceptions of neurodivergent traits can still refer to traits as symptoms, disabilities, or deficiencies. This contrasts neurodivergent traits against neurotypical ones, reinforcing notions of a neurotypical standard that autism deviates from and requires fixing. This language can make clients feel defective or flawed, especially if they are seeking understanding and validation rather than a “cure” or a checklist of areas for improvement.
Overlooking Sensory Needs and Sensitivities
“Somatic” and “sensory” may be psychology buzzwords, but insufficient understanding of sensory processing systems generally and potential differences in autism may create an environment that is uncomfortable or overwhelming for the client (e.g., bright lighting, intense scents, grating sounds like white noise). Not questioning the atmosphere and getting curious about sensory support can make the client feel unseen or fear their perceived as “too demanding” or “unreasonable”, deepening a sense of shame around their sensory experiences.
There’s very little I learn about better understanding and supporting autistic clients that isn't helpful to better supporting “neurotypical” clients. Wouldn’t all humans benefit from not being assumed to be the same as everyone else similar to them? Wouldn’t all humans benefit from relationships that approach difficulty with curiosity and compassion? Yes! Working with autistic clients in neurodivergent-affirming therapy with autism-informed approaches invites therapists to widen their lens, slow down and get curious. Note - none of these musings include requirements to know everything and get every moment right. Neurodivergent-affirming approaches means meeting our clients in a compassionate space that honours and supports the unique experience of that particular autistic client alongside increased awareness of neurodivergence needs and skills. In my experience, expressing humility with my autistic clients in a direct manner has been a gift in my clinical practice - “I’m not an expert on all dimensions of an autism spectrum experience, but I know some things. I hope you’ll correct me when I inevitably get something wrong.”
by Kathryn Anne Flynn
If you would like to book a consultation to explore therapy for your child on the autism spectrum or to discover if our approach to therapy with autistic clients is right for you, please reach out below or directly book a consultation.
