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Would you ever ... work with an Autistic Therapist?

Updated: Mar 15, 2023

I wonder if you would ever consider attending therapy with an autistic therapist. And, if you were to consider it, what might be your reservations? Would you be willing to explore the bases of these? And your potential learning edges? If so, read on!


"Coming out" as autistic when you are a therapist tends to be risky because of the prevailing dominant narratives and stereotypes around disorder, lack of empathy and coldness, to name a few examples.


While in some circles there is acceptance of the possibility that some therapists might be autistic, it can also be widely assumed that their work would only be valuable with other autistic people.


This article attempts to initiate dialogue around these themes and to raise awareness of key qualities of autistic therapists. To begin, I will offer a brief contextual overview of the neurodiversity paradigm which has become the cornerstone of my practice.


What is neurodiversity?


Neurodiversity refers to the diversity of human nervous systems ("neuro" as in "neurology"). The neurodiversity paradigm stands in opposition to the deficit / disorder framework which forms the foundation for the majority of the research and treatment of neurodivergent people over the past century.

The neurodiversity paradigm views neurodivergences as simply different ways of being human - "different not less". Neurodiversity affirms the necessity of autistic people not only being involved in the autism research but actually designing and leading it.


​In the words of Nick Walker, a prominent autistic writer and educator:


1.) Neurodiversity is a natural and valuable form of human diversity.


2.) The idea that there is one “normal” or “healthy” type of brain or mind, or one “right” style of neurocognitive functioning, is a culturally constructed fiction, no more valid (and no more conducive to a healthy society or to the overall well-being of humanity) than the idea that there is one “normal” or “right” ethnicity, gender, or culture.


3.) The social dynamics that manifest in regard to neurodiversity are similar to the social dynamics that manifest in regard to other forms of human diversity (e.g., diversity of ethnicity, gender, or culture). These dynamics include the dynamics of social power inequalities, and also the dynamics by which diversity, when embraced, acts as a source of creative potential.




What does it mean to be Neurodivergent?


A neurodivergent person's nervous system "diverges" - or differs significantly - from societal norms. We can be born neurodivergent (sometimes called innate neurodivergence) or we can acquire it later on.


Autism and ADHD are examples of innate neurodivergence while epilepsy and traumatic brain injuries are acquired neurodivergence. The neurodiversity movement does not oppose proposals to "treat" acquired neurodivergence because clearly this would not be tantamount to getting rid of core aspects of someone's personhood. This is very different to attempts to cure autism, for example, where there would be a very real attempt to get rid of core parts of someone's basic way of being and personality.


My Story


I am autistic. Simply realising and embracing this has led to major shifts in my self understanding and compassion. The biggest thing is that I realised once and for all that I wasn't "broken" or abnormal. I had lived for so many years with these gnawing suspicions, unable to access root "causes" or explanations despite years of therapy and personal work.


The conundrum for me and others looking on was that I appeared to be far away from the unhelpful stereotype of an autistic person which had been perpetuated via the media and medical / research circles. In addition, the very fact that I am a therapist with a successful career history seemed to obscure the possibility. Indeed, two well meaning psychotherapists I spoke about it with clearly told me they couldn’t see it when I broached the topic during therapy sessions.


​​Claiming and embodying my autistic identity was therefore a slow and gradual road for me. However, as many people know, being autistic usually means having intense and focused interests ... and in my case one of these became autism. Over the past 5 years I have been immersed in the neurodiversity movement, deconstructing and unlearning my own internalised ableism. This process is ongoing!


Unmasking as an autistic therapist

My professional identity has been a key area of exploration and challenge for me in recent years. I have been concerned about whether the dominant social and cultural narratives would jeopardise my career if I “unmasked” professionally. After all, my eye contact is good (when I am listening and focused on another person), I am insightful and highly empathic. I have consistently received positive feedback and people have chosen to work with me for long and in depth processes.


The game changer for me was in recognising that I haven’t been competent as a therapist because I have been “passing” as neurotypical (though that may be how an observer could see it). Instead, what if my competence comes from being autistic rather than in spite of being autistic?


Traits of an autistic therapist


I have compiled some ideas of common traits which autistic therapists may have.


Firstly, we notice, observe and pick up everything. Autistic therapists also tend to be particularly good at noticing patterns and inconsistencies. And, because we are so focused, our memories tend to be noticeably sharp. We can effortlessly retain information from many months ago and, usually via a kind of pattern recognition in the here and now, weave it back into current conversations.

Autistic therapists also tend to have a natural ability to make implicit material explicit. This may be because we don't have the same automatic filtering as might be the case for an allistic (non autistic) practitioner and therefore the material feels more easily accessible.


We naturally "think outside the box" and can often offer this to others who need creative solutions which may be obscured by meaningless social norms.


While autistic people can sometimes be viewed as blunt or rude according to social convention, our insights do not seem to be perceived that way in therapy (I’m open to further feedback on this!) Perhaps because as therapists in training we learn how to offer insights in a gentle and sensitive manner. Or maybe the “bluntness” is experienced more as “directness” within a therapy context and is therefore welcome.


Also, while we're not great at small talk, we are pretty comfortable with intensity and complexity! We're not very shockable - our minds have usually "gone there" and due to this we convey permission to others to access their own hidden or most intense thoughts and feelings.

​An unmasked autistic therapist has usually embraced their own uniqueness and therefore is very comfortable with and welcoming of idiosyncrasy and diversity in others. When there's no pressure to be "cool" or "normal" and you are in a room with someone who is neither of those things, you can become more liberated and free to explore.


Another bonus which comes with autistic therapists is that our standards are usually extremely high. We also will normally not stick at anything for very long unless it holds particular ("special") interest for us, meaning that if we have been in the therapy field for any length of time it is usually because we are committed and pretty heavily invested in it. There are numerous aspects of my career which an assessor could attribute to "special interest" status, from my endless curiosity about people to particular research and training topics.


We have usually also been propelled to some degree by a sense of being different and even of a sort of "imposter syndrome". Working through this and finding a niche where we are affirmed and appear to consistently meet expectations can allow us to relax into a place of 'flow" where we get to go "all in".

In terms of empathy, many of us are hyper-empathic. We have an exquisite capacity to "stay with" someone / something and to sense into feelings and emotions. The challenge is often around learning not to "lose ourselves" as opposed to struggling to grasp or engage with the material. I believe this tightrope is what has been so unhelpfully labelled as a lack of empathy by onlookers.


When an autistic therapist is working with an allistic person we offer genuine empathy in the sense that we really don't "get it" from the inside but we have the capacity to see things "as if" we were in your shoes. This always reminds me of my foundational person-centred counselling training: “To sense the client’s private world as if it were your own, but without ever losing the ‘as if’ quality” (Carl Rogers).


When an autistic therapist works with an autistic client, we often do actually “get it” from the inside. Just like when two allistic clients work together this could risk “blurring” and of course calls for professional discernment. At the same time, for autistic clients, it seems that – when managed well – self disclosure in this regard can itself be experienced as transformative as they have so rarely been “got” in that way. It is interesting, then, as an autistic therapist to work with the “me too” element in a helpful and unique way. And perhaps this is an example of how many of the traditional approaches need to be engaged with thoughtfully and at times adapted to fit the needs of autistic people.


What is autistic - affirmative therapy?


To wrap this up, I just wanted to mention some key elements which autistic therapists can bring to therapy processes with autistic clients.


Firstly, as mentioned above, sometimes therapy can be one of the first spaces where an autistic person experiences authentic autistic / neurodivergent culture - where they are seen and valued exactly as they are. This can then support people to unpack and get to know their own unique "neurotype". There is often a process of unlearning and reframing, which weaves and spirals its way through sessions.


There are common key areas within therapy for autistic people such as (un) masking, burnout and complex trauma. The research is gradually emerging and it is becoming clear that autistic people do not respond well, indeed often respond adversely, to traditional approaches to addressing these issues.


Finally, autistic – affirming therapy absolutely prizes people for exactly who they are, thereby supporting self compassion and ultimately freeing us up to live happier and more fulfilled lives. We also do not run away from the very real and ongoing difficulties of living in a neurotypical world. We validate the challenges and we offer practical signposting to relevant resources and support.


Thank-you for reading to the end. I am always happy to hear from anyone wanting to comment, offer feedback or ask questions. Email is best: sianamcgarvey@proton.me









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