Therapy when you're autistic or ADHD: what might help

If you're autistic, ADHD, or both, you may have had experiences of therapy that didn't quite land. Maybe the pace felt wrong. Maybe the therapist didn't get it. Maybe you left more exhausted than you arrived, and weren't sure why.

You're not alone, and it isn't your fault.

This is a short, honest post about what I've learned — through training, practice, and life — about what can make therapy work for neurodivergent adults, and what often gets in the way.

Why therapy can feel hard

A lot of traditional therapy is built around assumptions that don't always fit neurodivergent minds:

- That you'll feel comfortable with long stretches of eye contact and open-ended silence.

- That you'll naturally know what to say, in the moment, when asked an open question.

- That your emotions will arrive in order and be labelled clearly.

- That "just noticing your body" is easy.

- That talking is always the right way in.

For many autistic and ADHD adults, these assumptions quietly create a kind of invisible work — masking, translating, performing "the right way to be in therapy". And that work is tiring. It can also get in the way of the actual therapy.

What can help instead

In my practice, I try to let go of those assumptions and work with you as you are. That might look like:

- Being told what to expect. Less mystery, more clarity. You're welcome to ask how sessions work and what I'll do.

- Flexible communication. Talking is one way in. Writing things down, sending notes before a session, drawing, using lists, or sitting quietly are all valid too.

- Permission to stim, move, fidget, or look away. You don't need to hold yourself still for me. I'd rather you were comfortable.

- Breaks and pacing that suit you. If a topic is too much, we slow down or pause. You don't have to push through.

- Plain language. I'll say what I mean and check I've been understood.

- No pretending to be fine when you're not, and no pretending to be more broken than you are. Either extreme is exhausting.

It's not about "managing" your neurodivergence

I don't see therapy as a place to help you become more neurotypical. I see it as a place where you can understand yourself more clearly, grieve what needs grieving, unpick what isn't serving you, and find ways of living that fit the mind you actually have — not the one other people wish you had.

Sometimes that includes thinking about strategies or practical tools. But those are in service of you, not the other way round.

You don't need a diagnosis

Many of the people I work with are somewhere in the process of understanding themselves — with a diagnosis, on a waiting list, self-identifying, or just beginning to wonder. All of that is welcome here. You don't need a label to deserve support that fits you.

If you'd like to talk

If any of this sounds like what you've been hoping for, a free 20-minute call is a gentle first step. We can talk about what you're looking for, how I work, and whether it feels like a good fit. No pressure, no commitment.