Demystifying Therapy: A Neurodivergent-Affirming Guide for Those New to the Process

Become a Substack paid subscriber and gain access to our Blog Post PDFs. Scroll to end of the blog for more information.

Check out Substack for article voiceover

Introduction

For many individuals—particularly those who identify as neurodivergent—the idea of starting therapy can be daunting. Whether you're considering it to navigate burnout, process past experiences, or gain support in understanding yourself more fully, therapy often comes with a host of unknowns. If you've never engaged in therapy before, you might wonder what to expect, worry whether your experiences will be understood, or fear being pathologised for the ways your brain and body navigate the world. These concerns are valid and not uncommon. This blog offers a clear, compassionate overview of what therapy is—and isn't—through a neurodivergent-affirming lens, helping to reduce the uncertainty that can accompany beginning therapeutic work.

Understanding Neurodivergent-Affirming Therapy

At its core, it is not about "fixing" people. From a neurodivergent-affirming perspective, therapy should never aim to erase or suppress aspects of identity that fall outside neuronormativity. Instead, it serves as a collaborative space for growth, reflection, and understanding. This approach centres lived experience, prioritises autonomy, and recognises that challenges are often the result of environmental mismatch or systemic barriers—not inherent deficits (Chapman & Botha, 2023). Affirming therapists view neurodivergent traits—such as stimming, special interests, or sensory sensitivities—not as symptoms to be managed but as meaningful aspects of identity and culture (Mills, 2023). These expressions can be valuable tools for self-regulation and communication when properly understood and respected.

From Masking to Authenticity

Many neurodivergent people spend years masking their natural ways of being to fit into neuronormative environments. While this may offer short-term safety, it often leads to exhaustion, anxiety, and diminished self-worth (Cage et al., 2018). Therapy provides an opportunity to unmask—to show up as yourself, without judgement or pressure to conform. You might stim, use a fidget, take longer to answer, or communicate through writing or visuals. An affirming therapist will not only allow for this but welcome it. This process of unmasking can be deeply healing, especially when guided by a therapist who practices epistemic humility—that is, they recognise you as the expert in your own life (Chapman & Botha, 2023). Rather than imposing clinical interpretations, they listen and learn from your perspective, respecting your insights and autonomy.

It’s Not a One-Size-Fits-All Process

Therapy is often imagined as someone lying on a couch, speaking freely while a therapist silently takes notes. In reality, therapy can look very different depending on your preferences, needs, and goals. Neurodivergent-affirming therapy is adaptable—it might include visual aids, structured routines, movement breaks, sensory-friendly lighting, or alternative forms of communication. The process tends to be medium to long-term, especially when the work involves trauma, identity development, or unlearning internalised ableism. Many neurodivergent individuals have experienced misunderstanding or even harm in previous healthcare, school, or family systems. Building trust may take time, and that’s okay. A strong therapeutic alliance—based on authenticity and mutual respect—is foundational to effective support (Mills, 2023).

Therapy as Active Learning

Therapy is a space for learning about yourself and experimentation. This might include:

• Understanding executive functioning challenges: You may work with your therapist to identify where executive functioning challenges (like time blindness, task initiation difficulties) show up in your life and explore concrete tools—such as visual schedules, external reminders, or body-doubling techniques—that help support your day-to-day functioning.

• Exploring sensory profiles and regulation strategies: Sessions might include identifying which sensory inputs (like lights, textures, or sounds) help or hinder your wellbeing. Your therapist can support you in creating personalised sensory plans, exploring grounding techniques, or using tools like noise-cancelling headphones.

• Building self-advocacy or boundary-setting skills: You might practice ways to assert your needs in social, work, or healthcare settings. This could include role-playing difficult conversations, creating communication cards, or developing strategies for managing rejection sensitivity.

• Navigating communication differences: Therapy can be a place to safely practise interactions—like initiating conversation or managing small talk. It can also be a space to unpack why some forms of communication feel inaccessible and explore alternative methods, such as AAC, email, or written processing.

These strategies are tailored to you. For example, if you're autistic and struggle with interoception (internal bodily awareness), therapy might involve mapping out emotional or sensory signals. If you’re an ADHDer, you might use Spoon Theory or visual scheduling tools to manage energy and tasks. The emphasis is always on supporting you in ways that are relevant, respectful, and sustainable (Chapman & Botha, 2023; Mills, 2023).

Therapy Is Not About Being "More Normal"

A major fear for many is that therapy will push them to act more neurotypical. This fear is grounded in history—especially for autistic people, whose experiences with behaviourist interventions like Applied Behaviour Analysis (ABA) have often been coercive and traumatising (Wilkenfeld & McCarthy, 2020). In neurodivergence-informed therapy, the goal is not to make you blend in. Instead, therapy helps you explore your identity, manage distress, and navigate the world in ways that align with your values and goals—not society’s expectations. It’s a space where self-determination and dignity are prioritised over compliance and conformity (Chapman & Botha, 2023).

Reframing Dysfunction and Exploring Neurotype Dysphoria

Therapy often helps reframe how you understand your difficulties. For example, what may be labelled as "avoidance" could be a protective response to overstimulation or past trauma. Executive functioning struggles aren't moral failings—they reflect neurological wiring and environmental barriers. Affirming therapy recognises these patterns not as dysfunctions, but as contextual, relational, and adaptive. You may also experience what’s known as neurotype dysphoria—a term introduced by Chapman (2020) to describe the internal conflict that arises when your self-concept or aspirations clash with your neurological realities. Therapy can help navigate these tensions with compassion, helping you redefine goals in alignment with who you truly are.

Myths and Misunderstandings About Therapy

If you're new to therapy, it's natural to carry certain misconceptions—especially if your previous experiences with support systems have been invalidating or misattuned. These myths can contribute to hesitation or fear when considering therapy. Let’s unpack and reframe a few common misunderstandings:

Therapy is not a passive experience

There’s often a perception that therapy involves passively receiving advice or being “talked at.” In reality, therapy is an active, collaborative process. You don’t need to arrive with perfect self-awareness or a cohesive life story. It’s okay to not know where to start. Therapy is about exploring those uncertainties together. Engagement in therapy can take many forms and might shift from session to session. For some, it may involve talking at length. For others, it could be pausing for long silences, using writing, drawing, movement or objects to communicate. A neurodivergent-affirming therapist respects that communication and reflection do not look the same for everyone. You are also allowed to have fluctuating energy levels or capacity. On days where words are hard, your therapist might adapt by using visual prompts, providing grounding techniques, or simply sitting with you in supportive silence. Engagement doesn’t need to be verbal or intense to be meaningful. What matters is that the space is responsive to your rhythm.

Therapy is not about fixing you

A particularly harmful myth is that therapy is designed to “fix” what’s “wrong” with you. This narrative often stems from deficit-based models of disability and pathology. In a neurodivergence-informed approach, therapy is not about erasing traits or enforcing conformity to social norms. Instead, therapy supports you in gaining insight into your experiences, identifying what feels difficult or painful, and developing tools that align with your needs and values. It offers a compassionate space to process distress, unpack internalised stigma, and build trust in your inner voice.

Sometimes therapy helps people name and navigate trauma. Sometimes it helps clarify boundaries, explore identity, or reduce sensory or social overwhelm. But it never assumes that your neurodivergence is the problem. The goal is not to become “more normal,” but to create a life that honours your way of being. In affirming therapy, you get to define your goals. You choose what growth means to you. And your therapist walks alongside you—not as someone with all the answers, but as someone deeply committed to helping you access your own.

What You Can Expect from a Neurodivergent-Affirming Therapist

• Uses respectful, inclusive language: They use identity-first or person-first language depending on your preference, and avoid deficit-based labels like “disorder” or “low functioning.”

• Adjusts communication and sensory environments to your needs: This might include offering dim lighting, allowing headphones or stim toys, reducing conversational pacing, or supporting nonverbal communication.

• Invites feedback and co-constructs goals: Rather than dictating the agenda, they will ask what you want to focus on and adjust based on your evolving needs.

• Prioritises your safety and autonomy: You will never be forced to discuss topics or complete activities that feel unsafe. Consent and pacing are ongoing conversations.

• Validates neurodivergent expressions rather than suppressing them: Stimming, comfort items, and special interests are welcomed as part of your communication and self-regulation toolkit.

• Understands that distress often arises from systemic or relational factors: They will explore how social dynamics, environments, and past experiences contribute to your challenges, not just focus on changing your behaviours.

They may also openly discuss the therapy process itself—a practice called metatherapeutic communication—to ensure transparency and reduce anxiety (Mills, 2023). This might involve checking in about what feels helpful or unhelpful in the sessions, exploring whether the pace or structure is working, or collaboratively adjusting how communication happens. For many neurodivergent individuals, this level of openness helps clarify expectations, build trust, and reinforce that the therapeutic relationship is truly collaborative.

Starting Therapy: What Helps

If you’re considering therapy but feel unsure, you’re not alone. Many people—especially those who have never experienced supportive therapeutic relationships—feel intimidated by the unknowns. The good news is that neurodivergent-affirming therapists understand these uncertainties and are trained to meet you where you are. Here are some gentle, neurodivergent-affirming ways to ease into the process:

Bring your uncertainty into the session

You don’t need to have a clear “issue” or agenda to start therapy. A perfectly valid opening might be, “I don’t know why I’m here, but I know something doesn’t feel right,” or “I’m curious, but nervous.” Your therapist won’t expect you to arrive with everything figured out. In fact, naming your discomfort, hesitations, or confusion can be one of the most meaningful first steps. A neurodivergent-affirming therapist will be curious about your uncertainty rather than trying to eliminate it. They may ask reflective questions, help you notice what feels safe or unsafe in the moment, and co-create a plan for how to explore your experiences at a pace that honours your nervous system and preferences. Therapy isn’t a test—you’re not being evaluated. It’s okay if it takes several sessions before you feel ready to talk deeply or even know what you want to say. Your therapist is there to support your process, not to dictate it.

Start with low-pressure goals

There’s no rule that says therapy must begin with diving into your trauma history or resolving major life challenges. Many people benefit from starting with manageable, low-pressure goals that build confidence and trust. For example, you might begin by:

• Identifying what overstimulates or soothes your sensory system.

• Talking through what a “bad day” feels like and what helps you recover.

• Exploring how masking shows up in your day-to-day life.

• Mapping your energy levels across the week using Spoon Theory or a similar framework.

• Clarifying the boundaries you need in work, school, or relationships.

• Naming things that bring you comfort, joy, or relief.

These goals are foundational. They help create safety, build momentum, and give your therapist important insights into what support might look like for you. Over time, your goals may shift, and that’s welcomed. You’re allowed to evolve and reorient as you go.

Conclusion

Neurodivergent-affirming therapy offers a powerful alternative to traditional, deficit-based models. It centres your lived experience, honours your unique needs, and empowers you to lead your healing journey. For those new to therapy, especially those who have never felt fully seen in educational, medical, or mental health systems, this can be a radical and life-enhancing experience. Therapy isn’t about changing who you are—it’s about becoming more deeply yourself. And that’s a journey worth taking.

Access Blog Posts in Handy PDF Format - Exclusive for Substack Paid Subscribers

Looking to experience content in a more flexible way? By becoming a paid subscriber, you’ll unlock:

• Offline Convenience: Download and read at your own pace, free from the distractions of scrolling or notifications. Our PDFs put you in control, so you can engage with the content whenever and however best suits you.

• Accessible Formatting: We’ve thoughtfully organised headings, bullet points and spacing to help break down complex ideas into manageable chunks—ideal for neurodivergent minds that thrive with clarity and structure.

• Personal Archives: Build a personal library of insights, strategies and stories from Divergent Dialogues. Save PDFs for future reference, highlight key points, and revisit your favourites whenever you want to reflect or refresh your memory.

References

Cage, E., Di Monaco, J., & Newell, V. (2018). Experiences of autism acceptance and mental health in autistic adults. Journal of Autism and Developmental Disorders, 48(2), 473–484. https://doi.org/10.1007/s10803-017-3342-7

Chapman, R. (2020). Neurotype dysphoria. Psychology Today. https://www.psychologytoday.com/au/blog/neurodiverse-age/202006/neurotype-dysphoria

Chapman, R., & Botha, M. (2023). Neurodivergence-informed therapy. Developmental Medicine & Child Neurology, 65(2), 171–175. https://doi.org/10.1111/dmcn.15384

Mills, D. (2023). Applying a neurodiversity affirmative approach to the pluralistic framework. Counselling and Psychotherapy Research, 23(3), 627–637. https://doi.org/10.1002/capr.12637

Wilkenfeld, D. A., & McCarthy, A. (2020). Ethical concerns with applied behaviour analysis for autism spectrum “disorder”. Kennedy Institute of Ethics Journal, 30(1), 31–69. https://doi.org/10.1353/ken.2020.0000