Common Therapy Advice That is Counterproductive for Autistics

I’m a huge proponent of therapy. It can change a person’s mental state and wellbeing dramatically.

However, not all therapy and therapists are created equal. There are many different types of therapy designed for specific purposes (such as dialectical behavioral therapy that was created to treat borderline personality disorder).

Most therapists use what is called an “eclectic” approach. They blend the different modalities they have learned with their own life experience and personal preferences. In therapists who are intentional, well-educated, and invested in their therapeutic practice, this can lead to incredibly effective therapy.

However, even this “effective” therapy can miss the mark for autistic individuals. Most therapists are not educated beyond the basics about autism in graduate school. Unless they personally seek out additional education, therapeutic experiences with autistics, or have personal experience, they are not well-informed or educated about autism.

This can lead to two problems. First, an inability to recognize that the client sitting in front of them is autistic. Second, applying techniques and advice that are counterproductive for someone with an autistic mind.

I know the above is true in three key ways:

1. I experienced it as an undiagnosed autistic

2. I hear about it from my autistic clients’ experiences

3. Before I knew I was autistic, I was that therapist, which you can read about in my essay The Harm Done When I Didn’t Know I Was Autistic

Now that I have walked the journey of autism identification, sought out continuing education in autism, self-educated on autism, and worked with autistic clients… I know better. Much better.

And so, I would like to share some of the common therapeutic advice that people receive that is counterproductive for autistic individuals:

Be More Balanced

Balance is believed to be key for mental health. Therapists often advise people to have a good work/life balance. Clients are often advised to have a “healthy” mix of activities in their lives. Due to special interests, an autistic person is seldom “balanced.” Many autistics turn their special interests into their careers. They love spending time on their work both inside and outside of traditional work hours. To the untrained eye, this could look like an unhealthy obsession or that the person is a “workaholic.” In reality, autistics use self-interests to self-regulate. While most allistic people co-regulate with other people, autistics regulate better with objects (such as a computer game or puzzle), alone time, and their special interest.

I had a well-intentioned therapist who told me I should try reading something other than psychology in my free time. She knew I was in graduate school to be a therapist and she was concerned I was not balanced enough. She did not recognize I was autistic. What was the harm in her advice? It made me feel I was “wrong” for wanting to read more psychology. It caused me to feel shame anytime I wanted to read more.

Autistics already experience enough self-judgment and shame. Inaccurate advice adds to that shame. Furthermore, the advice to “be more balanced” robs them of the very thing that helps them to feel more balanced internally.

Get Out More

Human beings need connection and other people. It is a basic component of humanity. Therapists therefore frequently encourage clients “to get out more” and “socialize” and “meet more people.” Their intentions are pure - they want their clients to develop friendships and support systems.

However, we do not all need the same amounts of connection and socialization. For most autistics, the need for rest and recharge supersedes the need for socialization. This does not mean that socialization is not needed. It simply means that rest and recharge must come first. Then, when an autistic person person is resourced and recharged, they can choose to interact with people they find enjoyable. This will likely be a far smaller number of people and happen less frequently than allistic people.

Give People More Chances

Many autistics find it difficult to socialize and develop friendships with others due to misalignments. It is incorrectly assumed that autistics don’t know how to socialize. In reality, autistics are quite capable of socializing, they simply don’t enjoy it much of the time due to differences in expectations and guidelines around socializing. For example, many autistics despise small talk or listening to others who are incongruent (a nice way of saying hypocritical). I share more examples in my essay Stop Saying Autistics Cannot Socialize.

Autistics can quickly tell if a person aligns with them or not. When I complained to my therapist that I wanted more friends, she asked if I was getting out enough. When I explained the different people I had met and why I didn’t want to be friends with them, she advised me to give people more chances. I understand where she was coming from. She wanted me to find more topics to connect with people on. To set aside judgments and see the humanity in others.

The thing was, it was apparent to me what their values were and I didn’t want to be friends. I did not want to waste my time getting to know someone better when I felt their actions didn’t align with my values.

What my therapist didn’t realize is that she was encouraging me to question my intuition. She wanted me to ignore what my gut knew, and “try harder.” For autistics, the best thing we can do is listen to our intuition. We can develop far more meaningful friendships by no longer wasting energy in friendships that are unhealthy for us. When I focused on meeting people more aligned with my values and ways of being (such as my autistic friend who is also a liberation coach), I met badass friends. Yes, I have less friends than the average human, but I am far more happy with them.

Work with Every Thought in Your Mind

Another key component of therapy is to challenge unhelpful thoughts in the mind. For example, it can be beneficial to examine thoughts for cognitive distortions, such as catastrophizing. This is a common approach in Cognitive Behavioral Therapy techniques.

"Overwhelmed" Illustration by Jackie Schuld

However, this approach is not always effective for autistics. Autistics have SO MANY thoughts, that to sit with each of them and challenge them can be exhausting and counter-productive. It can cause an autistic person to obsessively monitor their thoughts.

When an autistic person is overwhelmed, sometimes the best approach is a distraction from the thoughts. For many, this means using their special interests to self-regulate and calm down. For others, it means taking a nap or sleeping through the night. Autistic people need this key time before they can calmly and effectively process their emotions and thoughts.

What else?

I’d love to hear your comments on other therapeutic advice or techniques that don’t align with autistic minds.

---

Thank you for reading. If you’d like to read more, sign up for my FUNletter. If you would like to explore your autistic identity with an autistic therapist, you can learn more about my therapy services here.