When therapy is not neurodivergence affirming
If you are neurodivergent and have been in therapy and have felt misunderstood, frustrated, or unseen, sadly, you are not alone
I know from my research that many neurodivergent adults find therapy helpful. However, many also describe feeling unseen, misunderstood or feeling pressured to fit neurotypical expectations that feel jarring or unhelpful. In my master’s research exploring the experiences of neurodivergent people in therapy, participants repeatedly described needing to educate their therapist about autism, ADHD, sensory differences, executive functioning differences and masking.
The problem isn’t always you
When therapy is missing the impact of neurodivergence it can be easy for discussions to focus only on you and what you are doing and not capture the impact of the world around you, that is not designed around your needs, and what this means for you.
For example, I know of clients that have been told:
You’re overthinking.
You need to try harder missing that they are already trying harder.
Your difficulties are caused by low self-esteem when it is more complex than that.
Delaying tasks is avoidance rather than an unmet need or regulation issue.
Exhaustion due to burnout is simply depression.
For many neurodivergent people, these explanations may not be a good fit.
Several participants in my research described executive functioning difficulties being seen as a lack of effort or motivation. Others reported that sensory overwhelm, autistic burnout, or communication differences were interpreted without understanding the impact of neurodivergence.
Therapy can be another place to mask
One of the sad findings was that many participants described not feeling safe to be themselves in therapy.
Some described spending months building the trust to begin unmasking while others felt pressure to fit in with neurotypical norms to make therapy work better and the need to translate their experiences for their therapist.
If you are using significant energy monitoring your communication, suppressing stims, hiding feelings, being misunderstood, or editing your responses it can be harder to benefit from the therapeutic relationship. However, if you feel safe enough to share these things openly with a supportive therapist they can be important clues about what it is like to be you in the world.
Understanding matters
Participants who reported positive experiences described therapists who:
Were curious rather than making assumptions based upon the therapist’s own experiences.
Adapted their communication style.
Validated neurodivergent experiences.
Were willing to learn without burdening the client with educating them about neurodivergence.
Recognised the impact of minority stress, masking, burnout and sensory overwhelm.
You are the expert on your experience and the therapist’s goal is to be open, respectful, affirming, and to enter into the world as it is from your perspective so that you can understand it more deeply and make sense of it together.
What does neurodivergence affirming therapy look like?
Neurodivergence affirming therapy recognises that differences in the way that we experience the world are part of the natural variation among human beings.
Therapy can help you make sense of the world as you experience it and to understand yourself taking account of how you communicate, process emotions, regulate attention, and experience your senses.
Neurodivergence affirming therapy should also talk about how the world around you, often infused with its neuronorms, affects and influences you and what, if anything, you can do about that.
If therapy has not affirmed your neurodivergence
An unsatisfactory therapy experience does not mean it always has to be that way with every therapist.
The challenge may not have been your willingness to engage, your motivation or insight. Perhaps the therapist did not fully understand your experience as a neurodivergent person and perhaps the experience is showing you something about the therapeutic approaches that are not right for you and what could be right for you.
From my research, I know that finding a therapist who is curious about your neurodivergence, understands the impact of masking and burnout, communication and sensory differences, and values your lived experience can make a real difference.
You deserve a space to be seen and understood, as your neurodivergent self, without having to justify why your brain works the way it does
About Silja Turville
I provide neurodivergence-affirming counselling and coaching for adults. My work is informed by both professional training and research into the experiences of neurodivergent people in therapy. Please get in touch if you would like to explore working together.