Neurodiversity-Affirming Therapy
The term “neurodiversity-affirming” or “neuro-affirming” therapy has taken off in recent years.
Neurodiversity-affirming therapy views neurodivergent traits as part of identity, not pathology, and focuses on supporting safety, autonomy, and well-being instead of masking or “fixing” differences.
I want to help dispel the mystery by describing what you can expect from me as a neurodiversity-affirming therapist.
To stim or not to stim: What kind of question is that?
You are exactly as you are for a good damn reason.
What You Can Expect
Your nervous system is the one you were born with. It is part of your identity. It is not the enemy, and it is not broken. This means that I don’t spend your precious therapy time trying to fix the ways your brain is hard-wired to work.
Sensory Accommodations
We can change the lighting, temperature, seating, etc. to suit your comfort. Sit on the floor for some floor time. Cover yourself in weighted items. Fidget to your heart’s content. I promise you I’ll probably have a fidget in my hands for myself. I respect eye contact preferences. I work to create a safe space to unmask, but I will never rush or pressure you to “unmask.”
Pacing or Session Structure Accommodations
Being affirming means respecting the way you function as well as recognizing that you may need some support. I like to check-in with my clients to see what their preferences are for pacing and session structure. Some of my clients want help slowing down, focusing, or structuring the session. Some of my clients need the space to verbally process without being interrupted. I’m here for all of it.
I take communication preferences into account. I give my clients plenty of time to speak or reply. For some clients, many questions in a row can feel overwhelming. Some clients may prefer creative expression, listening to music together, or want me to read something they wrote. There is no one right way to do therapy.
Humor is human, not a “defense” to be stopped. We can joke AND do the deep work.
Goal and Treatment Accommodations
My clients set their goals, including my teen clients. Parents are an important part of the process, and I deeply value their perspective. However, everyone (no matter their age) deserves therapy that prioritizes their goals and values. I will help you get curious about your values and tune into your inner wisdom so you can make choices that are right for you (and don’t leave you shut down).
I will not assume you should “push through.” For many clients, the focus is not on doing more, but finding ways to lower daily demands, make tasks easier, and accepting “good enough.” I offer my suggestions as invitations, which you are free to try or not try. I will not label you as difficult or resistant. I will trust your process.
Special interests are LIFE! Let’s talk about them. I love learning about my clients’ special interests. I find that special interests help us connect with our strengths, our zest for life, and our playful energy. These are all wonderful things in the therapy room.
I keep a humble attitude to feedback. I make mistakes. I always want to know if something I said or did didn’t sit right with you. I know this is often intimidating. Whenever you are ready to discuss it, I’m listening — whether it’s been a week or a year. Really. There is no time limit.
Why do I say “autistic” instead of “on the spectrum” or “person with autism?”
Person-first language
Often used when describing something acquired or episodic rather than identity-based
Example: I have a friend who is depressed.
Identity-first language
Used when we are talking about something you were born with, a part of your identity (aka not a disorder)
Example: I have an autistic friend.
We are unfolding, discovering, rediscovering all the time.
Types of Trauma and Distressing Experiences Neurodivergent People May Experience
Neurodivergent trauma isn’t always about a single catastrophic event. Often it’s about loss of autonomy, sensory overwhelm, and repeated invalidation by systems not built for neurodivergent nervous systems.
It’s also the pain of what didn’t happen. What you desperately needed and never got.
In other words, it’s complex. And because of this, it’s harder to put into words. So often, we can’t yet fully acknowledge we need and deserve healing.
A note about pathological demand avoidance (aka pervasive drive for autonomy or PDA):
PDA is a neurodivergent profile in which demands register in the nervous system as a loss of safety or control. These can be external demands (requests, expectations, schedules) or internal (needs, goals, bodily cues). PDAers live with a nervous system on fire, especially when their accommodation needs are not yet understood. It’s not any one demand, but the cumulative effect over time that causes trauma for PDAers.
In my work with PDAers and their loved ones, I share power, lead with curiosity, and approach with a very open mind. We will see where the session leads, what the vibe is on any given day.
Do EMDR, IFS, and other treatment approaches work with Autistic and ADHD people?
Many evidence-based therapy approaches are effective for autistic and ADHD clients and often simply require thoughtful adaptations for neurodivergent nervous systems. Every nervous system is different, so I approach my clients with curiosity rather than assumptions.
I have found EMDR, Internal Family Systems (parts work), and attachment-based therapy to be particularly powerful for neurodivergent clients when used flexibly. Each person’s experience with these approaches is unique, so I avoid assuming what will or won’t work and instead collaborate closely to find the right fit.
I might explore questions like:
How much, or how little, do you visualize in your mind?
Do you tend to search for the “right answer,” and need more time or space to reflect before responding?
Are you able to notice subtle bodily cues, like early hunger or fatigue, or do you usually notice only once the signal is intense?
Do invitations to take deep breaths or focus on your body feel grounding or triggering?
Do you prefer very detailed explanations, or do you learn best by figuring things out as you go?
In many ways, the principles of neurodiversity-affirming therapy are simply solid therapeutic principles for anyone:
Start with curiosity
Treat autonomy as paramount
Allow room for playfulness and creativity when appropriate
Genuinely enjoy the person you’re sitting with
If you’ve tried therapy before and it didn’t feel quite right, that makes sense. I invite you to try again with a neurodivergent-affirming therapist.