As an AuDHD psychologist and counsellor—someone living and working at the intersection of autism and ADHD—I often get asked: what’s it like doing therapy from the inside out? What changes when the person in the therapist’s chair is wired similarly to the person on the couch?
A lot, actually. And the more I sit with clients who are neurodivergent, the more I realise how much traditional therapy models miss or even misfire.
Therapy that fits our wiring
Let’s get something straight: most psychology training still teaches us to be blank slates. Avoid self-disclosure. Be neutral. Maintain professional distance. That’s lovely in theory—and works for some people—but it’s absolutely baffling for many of us who are autistic, ADHD, or both. We crave context, we build trust through shared understanding, and we tend to learn and heal through dialogue, not neutrality.
When I was first getting into therapy, both as a client and later as a clinician, I found myself bouncing off the walls of those traditional models. I didn’t want a therapist who nodded politely while I spiralled. I needed someone who could meet me in my messy, expansive mind—who wasn’t afraid to challenge me and didn’t treat my curiosity as pathology.
That’s what I try to offer now. My style is conversational, responsive, deeply contextual. I lean into internal family systems, narrative therapy, and other flexible frameworks that allow clients (and me) to bring our full selves into the room.
Modality matters—but not how you think
Clients often ask what modality is “best” for neurodivergent folks. And I get it—it’s tempting to want a neat answer. But the truth is, any modality can be helpful if the therapist adapts it well. EMDR, CBT, DBT, SFBT, somatic work—they all have their place. What matters more is how well they’re delivered, whether the therapist understands your neurotype, and how safe you feel in the process.
Personally, I love somatic approaches, but I also recognise they require a foundation of bodily safety. Many of us—especially those with trauma—aren’t in our bodies to begin with. We might need years of verbal processing before we can do anything remotely “somatic.”
And let’s talk about CBT. Classic cognitive behavioural therapy often falls flat for AuDHD clients. Why? Because most of us are already painfully aware of our thoughts. We’ve looped through them a thousand times. We don’t need to “identify the distorted belief.” We need someone to help us figure out why that thought won’t let go, what need it’s meeting, and how to gently loosen its grip without denying its truth.
The trauma isn’t a bug—it’s the body working
One of the most damaging messages I see in mainstream therapy is the idea that trauma is something to be “fixed.” That if we just work hard enough, we’ll stop having flashbacks, start sleeping better, stop overreacting.
But trauma isn’t a malfunction. It’s a perfectly reasonable response to harm. Even when the harm happened years ago. Even when the world insists we should be “over it.”
I don’t treat trauma as something to cure. I help people recognise it, integrate it, and make space for it. Think of it like a scar—it doesn’t disappear, but it changes shape, becomes less tender, stops defining your whole experience.
This work takes time. It takes safety. It takes the willingness to build a foundation before diving into the deep end.
Relational therapy: two humans, not one expert
I’m not a blank slate. I cry with my clients. I laugh with them. I tell stories. I reference 1980s songs and tv shows. I make bad jokes. I let my humanity show.
That doesn’t mean I turn the session into my personal soapbox. Every story I share has a clinical rationale. But I believe in modelling vulnerability and emotional accuracy. If I want my clients to show up authentically, I have to do the same.
Sometimes I get dysregulated. I’m human. And when that happens, I name it. I say, “You might’ve noticed something in me just now. That’s not about you. It’s something I’ll take care of.”
In doing so, I model repair. I show that therapists aren’t all-knowing authority figures—we’re just people with more training and different boundaries. That’s often what makes the therapeutic relationship transformative. It’s not the technique. It’s the experience of being with someone who sees you, hears you, and stays.
Working with giftedness and fast minds
Many of my clients are not just neurodivergent—they’re gifted. They think fast. They see patterns in everything. They’ve often run mental circles around therapists before.
Here’s what I’ll say to those folks: you’re not “too much.” But yes, you might need a therapist who can keep up. One who isn’t dazzled by your vocabulary or your insight. One who doesn’t retreat into praise instead of giving you the challenge you actually need.
It’s okay to ask for more. To say, “I need you to push back.” Therapy isn’t just about being heard—it’s also about being sharpened. And that only happens when both people in the room are engaged.
Online therapy, real impact
Let’s dispel the myth that online therapy is second-rate. For many of us with executive function challenges, sensory issues, or low capacity, virtual sessions are a godsend. No commute, no fluorescent lights, no trying to find a carpark while your nervous system’s on fire.
The research backs it up: teletherapy, when done well, can be just as effective as in-person. What matters most is the quality of the relationship—not whether we’re sitting across from each other or across the screen.
That said, there’s nuance. Some clients need the embodied co-regulation that in-person work provides. Others feel safer behind a screen. My advice? Do what works. Drop the guilt. The mode is only a tool.
Final thoughts: we’re in this together
If you’re AuDHD and seeking therapy, you deserve to work with someone who gets it. Who doesn’t just tolerate your tangents, your info dumps, your existential spirals—but sees them as valid parts of your process.
If you’re a therapist, and you’re neurodivergent, welcome. Your way of being is an asset, not a liability. You bring something to the field that’s desperately needed: lived experience, deep empathy, radical clarity.
Therapy isn’t about fixing people. It’s about being with them as they find a way to carry what they’ve been given. And if that way includes questioning the entire system, decolonising the model, and throwing the therapy rulebook out the window? Good.
We were never meant to fit inside the lines anyway.
Of all the modalities I’ve worked with, Solution-Focused Brief Therapy (SFBT) remains the one I return to most often. It’s deceptively simple—and beautifully aligned with neurodivergent minds. SFBT doesn’t ask clients to endlessly rehash the past. Instead, it focuses on what’s working, what’s possible, and what small shifts can ripple into bigger change. For AuDHD clients who may already be exhausted by overanalysis and self-doubt, this strengths-based model helps redirect energy toward momentum, not paralysis. It’s also inherently collaborative, which respects our agency and honours our unique perspectives.
